AFC Rushden and Diamonds Youth (Under 18) Trials Days Registration Form

The AFC Rushden and Diamonds Open Trials will be held on Tuesday 12th July from 7:45pm to 9:45pm
on the artificial pitch at Raunds Manor School and on Saturday 16th July from 10:00am to 12:00pm at
Raunds Town FC (grass training pitch). There is also an open fans meeting at 12:00pm on 16th July in
the clubhouse at Raunds Town FC which potential players are invited to attend should they wish to.
Please arrive 15 minutes before the official start time for player registration, wearing appropriate
clothing and with appropriate footwear to take part in the trials.
Trials are open to anyone born between 1st September 1993 and 31st August 1996.
To register for the trials, please complete the information below and bring it along with you on the day. A
parent or guardian will be required to sign your form before you can take part in the trials. If a
parent/guardian is not attending the trials with you, please bring along a copy of this form which
they have signed.

Name:..................................................................Age: ............ Date of Birth: ............................

Address: ...........................................................................

Postcode: ................................

...........................................................................................
Phone Number:................................... Emergency Contacts number: ................................
Emergency Contacts name: ........................................
Do you have any allergies or health problems which we need to be aware of, or are you
taking any medication:
........................................................................................................................................................
....................................................................................................................................................
Which trials will you be attending (please delete as appropriate)?
Tuesday 12th July - yes/no

Saturday 16th July - yes/no

Preferred Position(s): ............................................................................

Current Football Club: ...........................................................................
Previous Clubs: ......................................................................................
...................................................................................................................
What was the last competitive 11-a-side match you played in and when was it?:

......................................................................................................................................................
Why are you interested in playing for AFC Rushden and Diamonds?:
......................................................................................................................................................

Parent/Guardian Consent: I hereby release AFC Rushden & Diamonds and those
individuals acting on behalf of the club from any and all liability for injury to or damage
to the personal property of my son/the person to whom I am guardian (please delete as
appropriate) due to participation in the trials. I certify that my son/the person to whom I
am guardian (please delete as appropriate) is in good health and is able to participate in
all activities. If any attention is required for illness or injury, I give permission to the
medical officer/officers present to provide such care.
Parent/Guardians Name: ..............................................................................
Signed (Parent or guardian): ...........................................................................
Date: ...............................