Play Dharwad Football Club

Admission Form
Personal Information:
- Full Name:
- Date of Birth:
- Gender:
- Address:
- City:
- State/Province:
- Zip/Postal Code:
- Email Address:
- Phone Number:

Emergency Contact:
- Full Name:
- Relationship:
- Phone Number:

Football Experience:
- Previous Clubs (if any):
- Position(s) Played:
- Years of Experience:
- Achievements (if any):

Health Information:
- Any Existing Medical Conditions:
- Allergies:
- Medications Currently Taking:
Parent/Guardian Information (if applicant is under 18):
- Full Name:
- Relationship:
- Phone Number:
- Email Address:

Consent and Agreement:

I, ______________________________________, hereby acknowledge that I
have read and understood the rules and regulations of Play Dharwad Football
Club. I agree to abide by these rules and regulations and understand that failure
to comply may result in disciplinary action, including potential termination of
membership. I also understand that participation in football activities involves
certain risks, and I release Play Dharwad Football Club and its representatives
from any liability for injuries or damages incurred during such activities.

Signature: _________________________ Date: _______________

Parent/Guardian Consent (if applicant is under 18):

I, _________________________________________, hereby consent to my
child's participation in Play Dharwad Football Club activities and agree to the
terms outlined above.

Signature: _________________________ Date: _______________