PlayerReg2020 – Chesterfield Junior Blues FC

Player registration form season 2020-21

Player First Name *

Player Last Name *

Address line 1 *

Address Line 2

Postcode *

Registration Code given to you by your manager *

Team Name *

Date of Birth *

Medical Condition *

Please list any medical conditions or enter NONE

Email *

Confirm Email

Emergency Contact 1 *

Emergency Contact 2 *

Mobile Number 1 *

Mobile Number 2 *

Player Photograph

Drop your file here or click here to upload

Players who did not play for CJBFC last season are required to provide a passport style head/shoulders photograph of themselves

Player Identification

Drop your file here or click here to upload

Players who did not play for CJBFC last season are required to provide suitable ID for league registration. We accept a photo or scan of either the player's Passport or Birth Certificate

Parental / Guardian Consent

In the event that my son/daughter is injured whilst playing football/travelling to and from events, and I cannot be contacted, I agree to my child receiving medical treatment.

I confirm that my son/daughter agrees to play for CJBFC as their first club for all playing and training purposes and to give priority to CJBFC over any other football club.

By submitting this form I and my son/daughter agree to abide by the CJBFC codes of conduct and other rules and policies set out by CJBFC which meet the requirements of the FA's Respect Campaign

I understand that I must keep up with my subscriptions and that failure to do so could mean my son/daughter will not be able to play in matches. If subscriptions are not paid in full, or monthly payments are not up to date, then players will not be allowed to play in further matches, sign for the following season or receive an end of season trophy.

Playing kit remains the property of CJBFC and must be returned to the club in the event of my child leaving before the end of the 2 year kit lifetime.

I consent to my son/daughter being photographed and/or filmed at CJBFC events, training and matches, or when representing CJBFC, for example at Tournaments, and for pictures to be published by CJBFC, their sponsors, the FA and the press.

Parent or Guardian Name *

Relation to player *

Phone