WHEN USING THIS FORM AS AN EMERGENCY PLAYER REGISTRATION ON MATCH DAY YOU MUST HAVE THE FORM COUNTERSIGNED BY AN
OPPOSITION CLUB OFFICAL PRIOR TO KICK OFF.
NOTE THAT EMERGENCY REGISTRATIONS ARE ONLY ALLOWED FOR RESERVE TEAM MATCHES
Position In Club:
Club:
Signed:
Print Name:
SURREY COUNTY INTERMEDIATE LEAGUE (WESTERN)
SINGLE PLAYER REGISTRATION FORM
Season 2016 - 2017
USE BLOCK CAPITAL LETTERS
Incorrect completion of this Form will cause the Player Registration to be put on hold or be refused
First Names__________________________________________________________________
Surname_____________________________________________
Email Address_______________________________________
Mobile No______________________________
Date of Birth___________________Address______________________________________________________________________
Town____________________________________________________________________________________________County___________________________
Post Code___________________
Clubs registered with last season_____________________________________________________________________
Other Clubs registered with this season________________________________________________________________
I would like to have my name Registered as a playing member of
FC
(Club)
(a) I confirm that I am NOT registered with any other club in this League
(b) I confirm that I do not have any outstanding football debts
I shall conform to the FA RESPECT PROGRAMME CODES OF CONDUCT laid down by the club and the League
Has the Player ever played or registered with a Club outside England?
Yes / No
If “Yes” has the Player obtained an International Transfer Certificate from the FA?
Yes / No
Date Form signed:
Signed
Signed
/
_______ ______2016/17
(Player)
(Club Secretary / Officer)
TRANSFERRING CLUB’S APPROVAL
If a player is Transferring from one club to another, a £10 fee MUST be enclosed with this form and the secretary of club the player is
leaving MUST fill in this part of the form as per League Rule 8(I)
Print Name……………………..………..…………Secretary of………………………………….FC
Signed………………………………………………Date……………………201
This Single Signing On form is used for all new players wishing to register for your club, and is the only form that can be used to register players when the season has started. This form
must be with the Registration Secretary 24 hours before the game for a player to be eligible for 1st Team football. The form can be scanned and sent to the Registration Secretary
electronically. If a player registers on match day he can only play for the reserve team and the top section of the form MUST be filled in by member of the opposition (and only a
maximum of 4 players can be registers on match day).
NO PLAYER CAN SIGN OR TRANSFER TO A CLUB AFTER 31st MARCH FOR THAT SEASON.