Abingdon Eagles Basketball Club

 

PLAYER REGISTRATION FORM

 

Personal Details

Name:
Address:
Postcode:
Home Tel. No.:
Mobile No.:
E-mail:
Date of Birth:
Preferred Team No.:
Country of Birth:
Nationality:
Height
Ethnic Origin: (please highlight only one)	White British / White Irish White Other / Mixed White/Asian Mixed White/Black Caribbean Mixed White/Black African Mixed Other / Chinese Black Caribbean / Black African Black Other / Asian Bangladeshi Asian Indian / Asian Pakistani Asian Other / Other (please state) ___________________

 

Emergency Contact Details

Name:
Home Tel. No.:
Work Tel. No.:
Mobile No.:
E-mail:
Relationship:

 

Medical Details (please attach additional sheet if required)

Any Regular Medication:
Diet Requirements:
Allergies, i.e. sticking plasters/penicillin:
Any medical condition coaches should know about:

 

 

 

 

 

 

 

PLAYER AND PARENT DECLARATION FORM

 

 

We confirm that I have received and read the Rules and Constitution of Abingdon Eagles Basketball Club and agree to abide all therein. We confirm that all information given on this form is correct at this point in time and agree that should any information change we will inform the Club Secretary as soon as possible.

 

We agree that any emergency medical treatment and procedures can be carried out as necessary as advised by a qualified person (i.e first aider/paramedic/doctor).

 

We agree players travelling by minibus or other parent vehicle as appropriate for away fixtures.

 

 

 

 

 

Player Signature: ______________________________________________

 

Printed Name: __________________ Date: ______________________

 

 

 

 

Parent/Guardian Signature: ______________________________________

 

Printed Name: __________________ Date: ______________________