Registration for BTFC Player Development Centre

Sessions 6-7pm on Thursday evenings through July for boys and girls aged 7 -11

Should you have any issues using this form please contact Mike on mike@brackleytownfc.co.uk  please do not contact/email anyone else this will be the your quickest way to get an answer to your problem

Private & Confidential
Personal Details
Please input players name
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Please specify your email address.
Contact Details

Please provide the details of two people who we can contact if required, one of which must be a parent/guardian.

Primary Contact

Please specify your name
Please specify relationship to child
Please specify land line phone number, no spaces
Please specify mobile phone number, no spaces
Please specify email address.

Other Contact

Please specify your name
Please specify your relationship to child
Please specify land line phone number, no spaces
Please specify mobile phone number, no spaces
Please specify email address.
Medical Details
Please specify your doctors name
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Please specify doctors land line number, no spaces
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If yes, please provide details of the condition for which the player is taking medication, if none state 'None'

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If yes, please provide details, if none please state 'None'

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If yes, please provide details, if none please stae 'None'

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Disclosure

• Player - I agree to abide by the Rules and Codes of Conduct of Brackley Town Football Club, the league, and the FA

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• Parent/Guardian - I agree to abide by the Rules and Codes of Conduct of Brackley Town Football Club, the league, and the FA

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• Parent/Guardian - I give my permission for any appropriate medical treatment to be carried out

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• Parent/Guardian - I agee that photos or video may be taken whilst the above named player is taking part in any club or league organised activity

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Finally to complete accept our Terms & Conditions

Terms & Conditions - Please read our terms & conditions here and tick box below to confirm acceptance

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Please register to receive our Newsletter

BTFC Newsletters keep you updated on what’s new at Brackley Town FC including:

Latest team news - Football in the community news - Saints Community project news - And more

These Newsletters will normally arrive in your inbox at most once a month unless we have some urgent news that we think you might be interested in. There is an unsubscribe link on all newsletters, so you can unsubscribe at any time

All you will need is your Name and Email address SIGN UP NOW

Our Privacy & Data Protection Policy can be read here

Items marked with an * are required.

Once form completed click on 'Submit my registration' below.

You will receive an automated email confirming your registration

Thank you for your support BTFC

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