ࡱ> JLI7 bjbjUU 2P7|7| lfff" " " " 6 & & & & & [[[$ f[W[[[& & 1 [48& f& [BNf&  )p" @0z  Players Membership Application Players Details First NamesTelephoneSurnamesMobile numberDate of BirthEmail addressPost CodeSchoolParents Details & Emergency Details (for use if parents cannot be contacted) Parents NameContact NameEmergency NumberContact NumberMedical Details Doctors NameMedical problemsSurgery AddressBlood GroupTelephoneDate of last tetanusOther Details Any other information which the club might Need to know.g special needs or disabilitiesI wish to apply for player membership to Waterhall Stars F.C and confirm that the details above are correct. If any other these details change then 1 will notify the club immediately. I understand that my membership will continue annually until terminated by either the club or myself in writing. I have read the clubs code of conduct previously and agree to abide by this at all times. Players Name:Date:______ / ______ / _____ Junior Player Parental Agreement I am aware that my child ....................................................... has applied for Junior/Youth player membership to Waterhall Stars FC and confirm that the details given on the. Application forms are correct to the best of my knowledge. I will notify the club immediately of any change to this information. I understand that this information will be used solely for the purposes of the football Club and will not be disclosed to any other parties without my written consent. I accept that the club may use photographs of my child for the purposes of advertising the club and/or team in the local press and on the internet, and am aware that I can have them removed at any time by submitting a written request to the club secretary. I have read the notes and information regarding payments overleaf and I therefore attach a payment of _____._____ Parents Name:Signature:Date: Medical Treatment Agreement I, the parent/guardian of............................................................. authorize the use of medical Treatment, including urgent surgery or blood transfusions as and when required by my child by appropriately trained staff, be it First aid, Ambulance or Hospital care, whichever is required; in the event of myself not being immediately connectable. Players NameParents Name: Age Group Parents Sign & Date: 7WXwx;GIUXhjx{SU~)* = I K X CJ$aJ$CJaJ5>*5>*@B*CJaJph@B*CJaJph6 5CJaJ 6CJaJ5>*CJaJ5>*CJ(aJ( 5CJaJ5FXwx $$Ifa$$If_hYYYP $$Ifa$$If$$Ifl\j }O)  j h t0644 la_|YYYP $$Ifa$$If$$Ifl\j }O)  j h t0644 la_PYYYP $$Ifa$$If$$Ifl\j }O)  j h t0644 la;HIVW_]WWWW$If$$Ifl\j }O)  j h t0644 laWXijyz_YYYY$If$$Ifl\j }O)  j h t0644 laz{_]WWWW$If$$Ifl\j }O)  j h t0644 la_|YYYY$If$$Ifl\j uO)  r h t0644 la_YYYY$If$$Ifl\j uO)  r h t0644 la&ST_]WWW$If$$Ifl\j uO)  r h t0644 laTU~{{ysssj $$Ifa$$If d-DM w$$Ifl{0O) t0644 la)*l  _]]]]]]]WW$If$$Ifl\3)MT t0)644 la $If d$If g < ;99999$$Iflֈ& #O)  RQ t044 la< = J K Y Z [ \ g WN d$If$$Ifl\)- 3 t0)644 la$IfX \ g h | CJaJ 5CJaJ5CJaJ g h } ~  YWWWK *-DM $$Ifl\)  t0)644 la$If $a$ *-DM           !"#$%&'()*+,-.//0123456789:;<=>?@ABCDEFGHIJKLLMNOPQRSTUVWXYZ[\]^_`abcdefghiijklmnopqrstuvwxyz{|}~$a$0&P 1h. A!"#$%  i8@8 NormalCJ_HaJmH sH tH zz  Heading 14$$N*-D1$7$8$@&M ^Na$"5CJOJQJ\^JaJmH sH ^^  Heading 2$$1$7$8$@&a$"5CJOJQJ\^JaJmH sH <A@< Default Paragraph Font@@  Balloon TextCJOJQJ^JaJRYR  Document Map-D M CJOJQJ^JaJ  P + + Xwx;HIVWXijyz{&STU~)*lg< = J K Y Z [ \ g h } ~  0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000X  WzT < g /Li  !"#$%&'    4b$6&Bo^r3Avgnrb$YS`ǬP,hYrR$lQY@O+F+`ErR$lQY@O+F+`Erb$AoJ ,ʨQYÊrb$_0Ge.dIE)rb$?of0xar 0e0e     A@ A5% 8c8c     ?1 d0u0@Ty2 NP'p<'pA)BCD|E||s " 0e@        @ABC DEEFGHIJK5%LMNOPQRSTUWYZ[ \]^_ `abN E5%  N E5%  N F   5%    !"?N@ABC DEFFGHIJK5%LMNOPQRSTUWYZ[ \]^_ `ab@ 0(  B S  ? .4~ &SxX^gi :::XXvwUU22~[\_h}= = K K Z   The Dixons_C:\Documents and Settings\The Dixons\Application Data\Microsoft\Word\AutoRecovery save of 1.asd The Dixons'G:\1.07 WHS new APPLECATION FORM[1].docx;HIVWXijyz{STU< = J K Y Z [ \ g h } ~  @RR`RR P@UnknownGz Times New Roman5Symbol3& z Arial5& zaTahoma"qhDi&Di&7 !x20 =3QHP Waterhall Stars Football Club John Stratton The DixonsOh+'0 (4 P \ h t Waterhall Stars Football Club WatJohn StrattonrsohnohnNormalr The Dixonso2e Microsoft Word 9.0o@0@Ix@~)@~)՜.+,0 hp|  r   Waterhall Stars Football Club Title  !"#$%&'(*+,-./012345678:;<=>?@BCDEFGHKRoot Entry F2<)M1Table)WordDocument2PSummaryInformation(9DocumentSummaryInformation8ACompObjjObjectPool2<)2<)  FMicrosoft Word Document MSWordDocWord.Document.89q