Your Registration Data

 

 

Player Section

 

Team Age Group Under 15
First Name [44]
Surname [45]
Fan number if Registered 00000001
Date of Birth 1st June 2011
Mobile Number na
Email [48]
Address

th e hill
Post Code se99 999i
School the hill
School Post Code school
Previous Club southwark

 

 

Parents Section

 

Parent/Carer Parent
First Name [60]
Surname [61]
Date of Birth [126 format=”jS F Y”]
Fan number if Registered 000001
Mobile Number 999099900
Email secretary@dulwichhamletjuniorfc.co.uk
Address

12 Watlington Grove
Post Code SE26 5RR

 

 

Medical Section

 

Does the player have any allergies or medical conditions YES
If so please state here

hayfever
Is the player taking medication YES
If so please state here

pills
Is layer OK to administer medication unsupervised NO
If no, then suitable advice to be supplied to the team manager

yes
Supply another emergency contact and number
First Name [77]
Surname [128]
Relationship to player Mother
Date of Birth 1st January 1950
Fan number if Registered n/a
Mobile number 887881010

 

 

Agreement and Confirmation Section

 

It is a condition of a player joining Dulwich Hamlet Junior FC that the player and parents, guardians, carers, family and supporters of that player, agree to be bound by the club rules and to abide by our club’s Code Of Conduct at all times.

A signing on fee of £50 is payable on completion of this form and can be paid using our secure online payments portal with Paypal which appear automatically when the registration form is submitted.

A fee of £8.00 is due weekly and is to be paid monthly – £32.00 – for a period of eight months only. This is to be set up at the same time as the signing on fee is completed using our secure online payment portal with Paypal.

Any subsequent brothers or sisters joining the club in the same season as players will be entitled to a £15.00 discount on the signing on fee.

Complete the payment boxes as usual for any siblings and on confirmation of that by the manager’s, the club will refund the difference direct to the person who made the payment.

Training – All training subs will be collected by the team manager and should never be paid direct to the club.

It is also a condition of joining the club that all club functions/fundraisers will be supported by all.

I agree to the conditions stated above and that all the information provided is correct. YES
09/06/2025
[60] [61]
(Parent of [44] [45])