HIGHGATE RANGERS YOUTH FOOTBALL
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Application Form
(Section 1)
If you only have one child at the club, please skip to section four. If you have more than one child registered, please complete the section below.
Childs Details
*
Indicates required field
Childs Name
*
First
Last
Name of school
*
Date of birth
*
School Year (starting September 2023)
*
--
Reception
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Gender
*
Boy
Girl
Medical details
*
Additional Child
(Section 2)
2nd Childs Name
*
First
Last
School name
*
Date of birth
*
School Year (starting September 2023)
*
--
Reception
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Gender
*
Boy
Girl
Medical details
*
Additional Child
(Section 3)
3rd Childs Name
*
First
Last
School Name
*
Date of birth
*
School Year (starting September 2023)
*
--
Reception
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Gender
*
Boy
Girl
Medical details
*
Parents / Guardians details
(Section 4)
Parents
*
First
Last
Email
*
Relation to child
*
Father
Mother
Sibling
Grandfather
Grandmother
Uncle
Aunty
Other
Phone Number
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Emergency contact details
(Section 5)
Emergency contact name
*
First
Last
Emergency contacts phone number
*
Relation to Child
*
Father
Mother
Sibling
Grandfather
Grandmother
Uncle
Aunty
Other
Submit
Membership
Training
Skills Sessions
Order Kit
Contact
Birthday Parties
History
About us
Charity
UA-236094425-1