The following will be needed for registration:

1. A recent player headshot (photo of head and shoulders) that is to be associated with the player for this season.
2. Parent date of birth – this is required to connect you to your child in the FA matchday app
3. Card or Bank Account details for direct debit payment

Name:*

First Name*

Last Name*

First Name Required Last Name Required

Billing Address

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

-- Select Country -- United Kingdom (UK) Afghanistan Åland Islands Albania Algeria Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belau Belize Benin Bermuda Bhutan Bolivia Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Cook Islands Costa Rica Croatia Cuba CuraÇao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Republic of Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Norway Oman Pakistan Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Martin (Dutch part) Saint Pierre and Miquelon Saint Vincent and the Grenadines San Marino São Tomé and Príncipe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United States (US) Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wallis and Futuna Western Sahara Western Samoa Yemen Zambia Zimbabwe

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Phone:* Phone is Required

Parent Date of Birth:* Parent Date of Birth is Required

Child1 Full Name:* Child1 Full Name is Required

Team1:* Team1 is Required

ACADEMYDEVILSVILLIANSLIGHTNINGBEASTSGIANTSTROOPERSPHOENIXAVENGERSBLASTDYNAMITESPARTANS

Child1 Date of Birth:* Child1 Date of Birth is Required

Player1 profile photo:* Player1 profile photo is Required

Child1 - Any medical conditions?

Child1 - Any medical conditions?:* Child1 - Any medical conditions? is Required

No Yes

Child1 - Medical Notes: Child1 - Medical Notes is not valid

Child2 Full Name:* Child2 Full Name is Required

Team2:* Team2 is Required

ACADEMYDEVILSVILLAINSLIGHTNINGBEASTSGIANTSTROOPERSPHOENIXAVENGERSBLASTDYNAMITESPARTANS

Child2 Date of Birth:* Child2 Date of Birth is Required

Player2 profile photo:* Player2 profile photo is Required

Child2 - Any medical conditions?

Child2 - Any medical conditions?:* Child2 - Any medical conditions? is Required

No Yes

Child2 - Medical Notes: Child2 - Medical Notes is not valid

2nd Emergency contact name:* 2nd Emergency contact name is Required

2nd Emergency contact phone:* 2nd Emergency contact phone is Required

Medical consent. In the event that my child is injured whilst playing football/travelling to and from football events and I cannot be contacted on the above numbers, I hereby give my consent for my child to receive medical attention.

Medical consent. In the event that my child is injured whilst playing football/travelling to and from football events and I cannot be contacted on the above numbers, I hereby give my consent for my child to receive medical attention.:* Medical consent. In the event that my child is injured whilst playing football/travelling to and from football events and I cannot be contacted on the above numbers, I hereby give my consent for my child to receive medical attention. is Required

Yes No

Photo & Video consent. You agree that club officials can take and store pictures of your child in line with FA guidelines and for club records, PR, or and promotional purposes or to benefit training exercises.

Photo & Video consent. You agree that club officials can take and store pictures of your child in line with FA guidelines and for club records, PR, or and promotional purposes or to benefit training exercises.:* Photo & Video consent. You agree that club officials can take and store pictures of your child in line with FA guidelines and for club records, PR, or and promotional purposes or to benefit training exercises. is Required

Yes No

I consent this player wishes to play for Leigh United this season and can provide identification if requested by the league.*

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Password Strength

 

No val Please fix the errors above

Pay Leigh United FC

£40 / Month

Have a coupon?

Coupon Code: Invalid Coupon Coupon applied successfully

Terms: £40 / Month

 

• 

  Two Players – Initial Payment

  £40 / Month

  £40.00

Total

£40.00