O'NEILLS LEINSTER FOOTBALL LEAGUE
STANDARD PLAYER REGISTRATION FORM
SEASON 2016/17
SECTION A
Name of Club
Club Secretary Last Name
Club Secretary First Name
Player's Last Name
Player's First Name
Players Status
Players Street Address
D Y
S I
M A
N
T
K
A
E
S
M O
N O K
I M
D
U
B
Non-Amateur
L
I
N
F
C
☒
Amateur
AFFIX
PHOTO
HERE
Players Town/City
Players Country (or Dublin Area Code)
FAIR Number
Date of Birth (DD/MM/YYYY)
Player's E Mail Address
(Parent/Guardian E Mail if under 18)
Player's Contact Telephone Number
0
8
(Parent/Guardian Number if Under 18)
Club Last Registered With
League Last Registered With
SECTION B
(To be completed if Player is under 18 years of age giving authority to the player being registered with league and/or club)
Parent/Guardian Last Name
Parent/Guardian First Name
Parent/Guardian Signature
I hereby consent to be registered as a player for<
<
>for the season<
>(not having signed for any other club)
to play for
>. Once signed I agree to abide by the rules of the said League and the FAI.
Players Signature
Date
D
D
M
M
2
0
1
6
Y
Y
Y
Y
The details you provide on this form will be used and stored by your Club and affiliated League and may also be shared with other Clubs,Leagues,National and Divisional
associations and the FAI for the purposes of your participation in all football related activity. Your data will be stored in compliance with the Data Protection Acts and will not
be shared with any other body or organization without your consent unless such sharing of information is necessary for your participation in football competitions and
activities.
The FAI may forward information of interest to you in relation to events, commercial activities, ticketing arrangements or other related activities.
Please tick this box if you do not wish to receive any such information?
Club Secretary's Signature
☒
M. Sitenok
2
Date
D
Section C
(To be completed by League on receipt if Sections A and B are fully completed)
Date Form Received
Date Eligible to Play
Date
League Secretary/Registrar's Signature
By signing this form as League Secretary/Registrar, you agree that the Player details provided on
this form will be stored in compliance with the Data Protection Act and will only be used for
football related activity as entered into by the player
League Stamp
& Date
IF IT HAPPENS IN SOCCER ••• THE HERALD HAS IT
D M M
0
Y
1 6
Y Y Y