PAYFC Membership Form 2023/2024

PAYFC Membership Form 2023/2024

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Player Details & Fees		200 Club		Emergency Contact & Health Details		Declarations		Parent or Carer Details

Player Name
N/A

Required First Name Required Last Name
Player Date of Birth *
N/A

dd/MM/yyyy
Age Group *
N/A
Subscriptions
Payment Preference *
N/A

Annual Payment
6 x Payments

Memberships are collected by Direct Debit via GoCardless. Fees can be paid via one payment or via 6 equal monthly instalments commencing in October 2023.
Player Photo (only required for under 7 and above)
N/A
Upload file
Please upload a passport style photo no more than 2MB.
Player Address
N/A

Required House Number and Street Name Required Town County Required Postcode

Pembury Athletic (Youth) Football Club – 200 Club Membership *
N/A

I am already a member of the 200 Club
I would like to join the 200 Club
I do not want to join the 200 Club

The 200 Club is a great way of raising funds for PAYFC and to help us keep subs low. It also gives participant members the opportunity of winning substantial cash prizes for just £5 per month per entry in the scheme.
Number of entries per month required (enter number) entries
N/A
60% of the proceeds are disbursed in prize money with the remainder supporting the club’s running costs. The rules of the Lottery are displayed on the club website. Contact Name/Address: George Brand at Ash Barn, Maidstone Road, Pembury. TN2 4AD

Retained by age group Manager in case of emergency.
Emergency Contact 1
N/A

Required First Name Required Last Name
Emergency Contact Telephone 1 *
N/A
Emergency Contact 2
N/A

First Name Last Name
Emergency Contact Telephone 2
N/A
Medical Conditions
N/A
It is important that whilst in the care of the Club, during training or on match day, any medical condition(s) that the above named played may have is known to the person responsible for his/her welfare. Please supply details of any such condition, or medication being taken, below. This information will be treated as confidential and will be retained by the Club only.

General Consent Statement from Parents/Carers:
1. To behave in line with the requirements of the Parents/Carers Code of Conduct – you can view on the club website or in the pavilion
2. To assist Age Group Managers with setting up and dismantling goals for training and matches, when requested
3. To assist with Pavilion duties, when requested
4. To assist with other club events, e.g. the club tournament.
5. To permit unnamed images of this named player to appear on the club website, club Facebook and club Twitter accounts
General Consent Statement from Parents/Carers: *
N/A
Key club rules:
1. There is a Club Ethos and Streaming Policy which all age groups adhere to.
2. Please arrive at least 10 minutes before your designated training time. For matches always arrive at the ground no later than 30 minutes before kick off.
3. Please accept that no player has an automatic right to play the position he/she wants. Remember, football is a team game.
4. Shin pads must be worn for all training sessions and matches. Each player must provide their own shin pads and football boots. The 3G surface requires plastic moulded studs or astro turf trainers.
5. Any player issued with team kit, will be held responsible for any damage caused. Should a player leave the Club, the kit (unless paid for by the player themselves) must be returned to the team manager as it remains the property of Pembury Athletic (Youth) F.C
6. In the event of any dispute between a parent, player, coach or manager, all parties should in the first instance seek to resolve the issue/concern privately via a face to face meeting. If an agreement cannot be reached then the party with the grievance should refer the matter to the Club Chairman and Club Secretary whose decisions will be viewed as final.
7. IMPORTANT: Any player incurring Kent FA punishments/fines may be asked to meet with the Club Committee to explain their behaviour and may receive a formal warning or may be asked to leave the Club. All players are responsible for paying any Kent FA fines and will not be selected for games until payment has been made.
Key club rules: *
N/A

Parent or Carer
N/A

Required First Name Required Last Name
Parent or Carer Date of Birth *
N/A

dd/MM/yyyy

(required by the FA Whole Game Player Registration system)
Parent or Carer Contact Telephone *
N/A
Parent or Carer Email *
N/A
Parent or Carer Signature *
N/A

E-Signature Field
Clear

PAYFC Membership Form 2023/2024

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