2025 - 2026 Registration Form - Leighton Corinthians YFC

Player's Full Name*

I (The Player) agrees to become a member of Leighton Corinthians Youth Football Club ( “the club” )I agree to abide by the rules and regulations and to uphold the sporting tradition of the club.

We have read and agree to the Player & Parent Respect Agreement form. This form is available on our club website information section.

https://www.leightoncorinthians.co.uk/information/player-parent-respect-agreement-form

The following information is required by the Club’s Secretary to comply with the requirements of the various sports representative bodies such as the Football Association and the MKDDL to whom this information may be supplied.

Players Nationality ( Please select from dropdown list )*

If "Other", please specify

Address*

Postcode*

Primary Contact Name*

Primary Email Address*

Primary Phone Number*

Secondary Contact Name*

Secondary Email Address*

Secondary Phone Number*

Third Contact Name*

Third Contact Email Address*

Third Contact Phone Number*

Players Date of Birth*

Players Date of Birth

Players Gender*

Age Group ( Please select from dropdown list )*

Medical History - Does the above named child have any Medical Conditions / Allergies of which the club should be made aware of?*

If yes, please provide information

I understand that whilst all reasonable care will be taken with the child named above during their activity within the club, in the unfortunate event of any medical emergency I DO / I DO NOT consent to medical treatment being given.

I DO
I DO NOT

Permission to use child's name and photographs. Player's name and photographs maybe reproduced e.g on the club's website or social media platforms

I DO
I DO NOT

Please read and sign the following statement. "In the event that I ( the parent / guardian ) am unable to transport my child to a team football match / training session, I give permission for another team members parent / guardian / adult ( known to me ) to transport my child ( Excluding club officials)"*

Player Head Shot Photo - Passport Style (New and existing players)*

New players joining the club will also need to supply a copy of a birth certificate or passport. This will be retained by the club for league registration purposes.

New players joining the club will also need to register with the FA by creating a FAN number. This is needed to be able to register your son/daughter to play league matches. Please see our information page - https://www.leightoncorinthians.co.uk/information/creating-a-fan-number-with-the-fa-new-players

The FA also require 1 x PARENT of each player to have a FAN number. If you don't already have one, please use the link above to register. Please complete the box below with the FAN number*

Full Name used on FAN Number Regisitration*

DOB used for FAN number registration*

DOB used for FAN number registration

CURRENT YEAR SUBSCRIPTION

Under 6s £80.00

Under 7s to Under 12s £165.00

Under 13s to Under 14s £180.00

Under 15 to Under 16s. £210.00

Under 17/18s £220.00

Younger playing siblings receives a 50% discount on these fees.

(Limited to 1 discount per family)

No sibling discount for players within the U6 training team

SUBSCRIPTIONS AND PAYMENTS

Payments can be made in full or a minimum 50% deposit is required by 1st July 2025.

Followed by a further 2 payments ( Please note we will not be accepting cash or cheques )

25% by 15th September 2025

25% by 15th October 2025

Under 6s = £80 (£40/£20/£20)

Under 7 to Under 12 = £165 (£85/£40/£40)

Under 13 to Under 14s = £180 (£90/£45/£45)

Under 15 to Under 16 = £210 (£110/£50/£50)

Under17/18s = £220 ( £110/£55/£55)

You can set up a standing order / Bank Transfer via online banking, using the following details:

Name of person you are paying: Leighton Corinthians

Sort code: 53-70-11

Account Number: 07686579

Payment Reference: Please use your child's age group and their initials

( Example U14MK)

Payment Reference*

Fees are based on a football season which runs from 1st September to 31st May. Summer training is on a team by team basis, arranged by the indivdual managers.

Player's Signature*

Date*

Date

Parent / Guardian's Signature*

Date*

Date

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