Peterborough and District Junior Alliance League

PETERBOROUGH AND DISTRICT JUNIOR ALLIANCE LEAGUE Sponsored by HEREWARD TEAMWEAR AND TROPHIES APPLICATION FOR MEMBERSHIP 2017/2018 SEASON PRINT CLEARLY Club Name: FA Charter Standard: Yes No

Entry Forms to be received by the League General Secretary no later than 1 st June 2017 By Post to: Hazel Burgess Birchfield. 123 Dog Drove North. Holbeach Drove. Spalding. Lincs. PE12 0SA By Email: [email protected] Please enclose cheque with form made payable to the Peterborough Junior Alliance for (£50 for Youths 9v9 & 11v11 teams) (£40 for all Youth Mini-Soccer U/7 – U/10) Girls: £25

County FA Affiliation Number required by 1 st July 2017: Do not enter last seasons leave blank if not known Cambs: Hunts: Leicester: Lincs: Norfolk: Northants:

Name of Secretary: Address:

Home Telephone number: Mobile: Email Address:

Name of Chairman: Address:

Home Telephone number: Mobile: Email Address:

Name of Treasurer: Address:

Telephone Number: Mobile: Email Address:

1st Welfare Officer Name: CRC expiry date: Safeguarding expiry date: Email address: Mobile: 2nd Welfare Officer Name: CRC expiry date: Safeguarding expiry date: Email address: Mobile: Fixture Secretary Name if have one: Address: Home Telephone Number: Mobile: Email Address: PETERBOROUGH AND DISTRICT JUNIOR ALLIANCE LEAGUE Sponsored by HEREWARD TEAMWEAR AND TROPHIES 2017/2018 Season

Enter number of teams you wish to enter for each age group in boxes U/7 U/8 U/9 U/10 U/11 (9v9)

U/12 (9v9) U/13 (11v11) U/14 Girls U/11 Girls U/12

Girls U/13 Girls U/14

Personal Accident Insurance: The General Secretary will require a copy of Clubs Personal Accident Insurance by 31st August 2016. This can be organised by any of the following County FA's to which Clubs are affiliated to Hunts, Cambs, Lincs, Leicester, Northants, and Norfolk

ENTRY FEE COSTS Entry Fee’s Youths : Mini-Soccer - £40 per team 9 v 9 and 11-a-side - £50 per team

All New Clubs entering the League will be required to pay a deposit of £50 (Rule 3D)

Girls all age groups: £25 (to be invoiced pre-season) Include payment with League Entry Form, cheques made payable to (The Peterborough Junior Alliance League)

Member Clubs applying for re-entry to the League for the 2017/18 season must be FA Charter Standard

New Clubs entering the League will be required to apply for FA Charter Standard within their first season of playing in the Peterborough Junior Alliance League.

The Peterborough Junior Alliance is an FA RESPECT LEAGUE and all Club Officials, Players, Parents/Spectators must follow and sign THE FA RESPECT CODE OF CONDUCT, to be shown on request from the League.

Signed: Club Secretary Date: PETERBOROUGH AND DISTRICT JUNIOR ALLIANCE LEAGUE Sponsored by HEREWARD TEAMWEAR AND TROPHIES 2017/2018 Season TEAM INFORMATION (ONE SHEET PER TEAM)

Team Name: Youths / Girls: (delete) Age Group: U/ Manager/Coach name:

Address:

CRC expiry date: ** Safeguarding expiry date:** Home Telephone number: Mobile number: Email address: (print clearly)

State Coaching qualifications:

Member of FA Licensed Coaches Club: Yes / No Registration number required: Kick off times Girls & Mini-Soccer Saturdays : 10.30 11.30 **Do not enter all Mini-Soccer ko at the same ie:- two games one referee can do 10.30 & 11.30. ***we will not supply a referee if all ko times are the same (ie: 3 games 3 referees) Kick off time 9v9/11v11 Sundays: (choose one only & circle ) 10.30 12.00 2pm As with Mini-Soccer do not enter all ko times the same you must use all three ko times to help with appointing referees. Ground address including postcode:

Colours: (Note: No Black or all Dark colours are allowed)All shirts must have numbers clearly marked in English not Roman visable on the back (not front) Players names are not allowed.

Shirts………………………………………………Shorts…………………………..socks…………………………………..

Assistant Coach/ Club person: ** To take charge of team in absence of Manager Assistant Coach Name:

CRC expiry date: ** Safeguarding expiry date:** Home Telephone number: Mobile Number: Email Address: (print clearly)

Member of FA Licensed Coaches Club: Yes / No Registration number required: **Mandatory