Stepaside FC

* Your name (payer)

* Your email (for receipt)

* Your mobile number

* Address

* Child 1: First Name

* Child 1: Last Name

* Child 1: DOB

* Child 1: GenderMaleFemale

* Child 1: Is this child a member of Stepaside FC?YesNo

* Child 1: Current Team

* Child 1: World Cup Entry

* Child 1: Please indicate whether this person has allergies, conditions or medication requirements, which may impact their health, welfare, learning or behaviour while participating in our activities. If answering Yes, then please remember to provide the coach with more details before this member participates in activities.

* Child 2: First Name

* Child 2: Last Name

* Child 2: DOB

* Child 2: GenderMaleFemale

* Child 2: Is this child a member of Stepaside FC?YesNo

* Child 2: Current Team

* Child 2: World Cup Entry

* Child 2: Please indicate whether this person has allergies, conditions or medication requirements, which may impact their health, welfare, learning or behaviour while participating in our activities. If answering Yes, then please remember to provide the coach with more details before this member participates in activities.

* Child 3: First Name

* Child 3: Last Name

* Child 3: DOB

* Child 3: GenderMaleFemale

* Child 3: Is this child a member of Stepaside FC?YesNo

* Child 3: Current Team

* Child 3: World Cup Entry

* Child 3: Please indicate whether this person has allergies, conditions or medication requirements, which may impact their health, welfare, learning or behaviour while participating in our activities. If answering Yes, then please remember to provide the coach with more details before this member participates in activities.

* Child 4: First Name

* Child 4: Last Name

* Child 4: DOB

* Child 4: GenderMaleFemale

* Child 4: Is this child a member of Stepaside FC?YesNo

* Child 4: Current Team

* Child 4: World Cup Entry

* Child 4: Please indicate whether this person has allergies, conditions or medication requirements, which may impact their health, welfare, learning or behaviour while participating in our activities. If answering Yes, then please remember to provide the coach with more details before this member participates in activities.

* Emergency Contact Name (if you cannot be contacted)

* Emergency Contact Number (if you cannot be contacted)

* I am aware that my Children's photograph or video image may be taken whilst attending or participating in games or activities connected with the Club and I consent to it being used by the Club for items like match programmes, year books, match reports, event reports or on the Club website or social media channels.

Founded 2018

Stepaside FC

Dublin

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