2016-17
MIDDLESEX COUNTY FOOTBALL LEAGUE
SATURDAY NEW PLAYER REGISTRATION FORM
Please complete this form in ink and in CAPITAL letters
To be completed by player
CLUB NAME
______________________________________________________
PLAYER’S FIRST NAME(S)
______________________________________________________
PLAYER’S SURNAME(S)
______________________________________________________
DATE OF BIRTH
______________________________________________________
PLAYER’S ADDRESS
______________________________________________________
______________________________________________________
________________________________ POSTCODE ____________
EMAIL ADDRESS (optional)
_________________________ MOBILE (optional) _____________
PREVIOUS CLUBS
______________________________________________________
PLAYER’S SIGNATURE
_________________________________ DATE ________________
PLEASE ENSURE A PHOTOGRAPH OF THE PLAYER IS ALSO SUBMITTED
To be completed by authorised Club Official
Has the player ever played or registered with a club outside of England?
YES / NO
If yes, please include the International Registration Transfer Certificate, obtained from The FA
I certify and confirm that I have checked the above details and they are correct. I accept that I am responsible for the accuracy of the details on the player
registration form. Where applicable, I have checked with the player’s former club that the player has no liabilities owing to them. I confirm that I have checked
with the County FA and that the player signed above is eligible to play. As Club Secretary, I confirm that the said player has read the code and the club will
ensure, to the best of its ability, that the player abides by the code.
CLUB OFFICIAL’S NAME
_______________________________________________________
POSITION WITHIN CLUB
_______________________________________________________
CLUB OFFICIAL’S SIGNATURE __________________________________ DATE ________________
The information contained on this form will be held on The Middlesex County Football League’s database. If you do not wish for your
details to be passed to approved sources, you should write to The League Secretary requesting your details are withheld. All players are
protected under the Data Protection Act 1998.
When complete, please email this form to [email protected] or post to
Warren McMahon, 14 Shearwater Drive, The Willows, Torquay, Devon TQ2 7TL
ISSUE 1 Warren McMahon 22/05/2016