DEWSBURY RANGERS IS AN FA CHARTER STANDARD
COMMUNITY CLUB
JUNIOR REGISTRATION FORM SEASON 2017 – 18
TO BE COMPLETED BY A PARENT OR GUARDIAN ONLY
PLAYERS NAME: - ……………………………………
DATE OF BIRTH: - ……………………………..
AGE GROUP: - UNDER……………’S ………….BOYS/GIRLS (DELETE AS REQUIRED)
ETHNICITY: - (PLEASE CIRCLE)
White, Black African, Black Caribbean, Black Other, Indian, Pakistani, Other
ADDRESS: - ………………………………………………………………………………………………………..
….. ……………………………………………………………………………………………………
POST CODE: - …..…………………………………………………………………………………..………………
CONTACT TELEPHONE NUMBERS: -
HOME: -……………………………………….……………………
MOBILE: -………………………………………………………….
E-MAIL ADDRESS: - ……………………………………………………………………………….……………..
Are there any medical conditions affecting your child that we should be aware of, for example asthma?……………………………………………………………….……………………………………………………..
Do you have any objections to photographs being taken of your child from time to time, and being published in the local
press or the Dewsbury Rangers website? We will endeavour to ensure that no details of the child’s identity are made public.
I agree/ disagree that my child’s image may be used (Please delete as necessary)
SIGNED BY PARENT/GUARDIAN: - ……………………………………………… DATE: - ………………..
PLEASE NOTE – By signing this registration form I also agree that my family and I will abide by the Club’s code of
conduct (see your attached copy for details). The Management Committee reserves the right to apply disciplinary measures to
any player or parent who breaks the club’s codes of conduct or rules. Any player or parent fined by any of the leagues that the
club is entered into may be asked to reimburse the club the total amount charged – reimbursement must be made within 14
days of notification otherwise a temporary suspension may be applied.
PLEASE ENCLOSE THE £40 REGISTRATION FEE WITH THIS FORM (Cheques payable to Dewsbury Rangers
JFC) and return to your team manager within 7 days of issue.
SUBSCRIPTIONS ARE £90 ANNUALLY; this can be paid at £15 per month from September to February 2018
OR AS A ONE OFF LUMP SUM OF £75, WHICH INCLUDES AN EARLY PAYMENT DISCOUNT OF £15.
(This will be available if this amount is paid in full before the 31st of October 2017, these subs are payable whether a player
trains or is selected to play).
All players must be registered with Dewsbury Rangers to be considered for team selection or registration with the applicable
league, but please note that registrations and regular attendance at training sessions does not guarantee team selection. Players
registered before the 31st of January 2018 must pay a full registration fee, registration after that date requires 50% of the
registration fee – normal subscriptions apply at all times.
However unlikely the event of injury is, children in the younger age groups must be accompanied by a responsible adult at all
times. Finally, whilst every effort will be made to ensure the safety of your child whilst training or playing for Dewsbury
Rangers, we cannot be held liable if any accident occurs during this time. Please make every effort to let your coach know
who is collecting your child.
PLEASE HELP US TO RAISE MORE MONEY FOR YOUR CLUB
THE REGISTRATION FEE YOU PAY CAN HELP US WITHOUT IT
COSTING YOU A PENNY MORE
PLEASE COMPLETE THE GIFT AID DECLARATION AND WE WILL
DO THE REST.
Gift Aid declaration –for a single donation
Name of charity or Community Amateur Sports Club
DEWSBURY RANGERS JUNIOR FOOTBALL CLUB
Please treat the enclosed gift of £40 as a Gift Aid donation.
I confirm I have paid or will pay an amount of Income Tax and/or Capital Gains Tax for
the current tax year (6 April to 5 April) that is at least equal to the amount of tax that all
the charities and Community Amateur Sports Clubs (CASCs) that I donate to will reclaim
on my gifts for the current tax year. I understand that other taxes such as VAT and
Council Tax do not qualify. I understand the charity will reclaim 25p of tax on every £1
that I have given.
Donor’s details
Title ------------- First name or initial(s) -------------------------------------------------------------------------Surname -------------------------------------------------------------------------------------------------------------Full Home address ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Postcode ---------------------------------Date -----------------------------------------------------------------------Signature ---------------------------------------------------------------Please notify the charity or CASC if you:

Want to cancel this declaration

Change your name or home address

No longer pay sufficient tax on your income and/or capital gains.
If you pay Income Tax at the higher or additional rate and want to receive the additional tax relief due
to you, you must include all your Gift Aid donations on your Self-Assessment tax return or ask HM
Revenue and Customs to adjust your tax code.
Please return this form to your team coach at the same time as the players
registration form.
DEWSBURY RANGERS JUNIOR FOOTBALL CLUB
ACCEPTABLE CODES OF CONDUCT
PARENTS/GUARDIANS/CARERS CODE OF CONDUCT
1. Do not force an unwilling child to participate in football.
2. Remember children are involved in football for their enjoyment, not yours.
3. Encourage your child to play to the laws of the game and not to argue with referees
and other officials.
4. Teach your child that honest effort is more important than victory so that the result of
each game is accepted without undue disappointment.
5. Turn losing into winning by helping your child work towards skill improvement and
good sportsmanship. Never ridicule or yell at your child for making a mistake or
losing a game.
6. Remember that children learn best by example. Applaud good play by your team and
members of the opposition.
7. Do not question the referee's judgement or honesty. Remember he/she is only human
with the same feelings as you and, like you, sometimes may make an honest error.
8. Support all efforts to remove verbal and physical abuse from children's football.
9. Recognise the value and importance of coaches who are all volunteers. They give their
time and resources to provide football for your child.
10. Read the laws of the game to understand better, what you are looking at and
commenting on, and finally, promote this code of conduct.
11. Dewsbury Rangers JFC reserves the right to ensure that a parent is present at training
or matches, if their child is unruly or for other disciplinary reasons (All age groups).
I agree that my family and I will abide by the Dewsbury Rangers code of conduct (signed on
Dewsbury Rangers JFC Registration form)
PLEASE KEEP THIS COPY FOR YOUR RECORDS
Further details can be found at WWW.thefa.com. 2001 The Football Association.