Club Officials Registration

Membership Details

Birchwood Team affiliated to(Required)

Club Member Name(Required)

First Last

FA Fan Number(Required)

Date of Birth(Required)

Day

Month

Year

Contact Number(Required)

Email Address(Required)

Position(Required)

Committee Member

Team Manager/Committee Member

Coach

Team Referee (Blue Card)

Parent Helper (Including Linesman)

FA Respect Marshal

Safeguarding(Required)

I have received a DBS check

I have completed the Safeguarding Children course

I have received emergency first aid training from an FA approved provider

I have completed the FA Level 1 “Introduction to coaching"

Please tick the applicable boxes

The below information can be found on our News and Information page.

Club Membership Agreement(Required)

Whilst I remain a club official with Birchwood Colts JFC, I agree to all the Policies and Codes of Conduct.

Committee Members Agreement(Required)

I agree to accept Committee member responsibilities as per the Birchwood Colts JFC Club Constitution

Submission

Name

First Last

Date

DD slash MM slash YYYY