Registration

£75.00 jan 31,

Annual Membership

Date	Amount
Jan 31,	£75.00
Jul 31,	£75.00

First name

Last name

Address line 1

Postcode

City

Mobile

Date of birth

FAN (This is your membership number issued by the FA at theFA.com registration. Please check if you already have one before registering a new account))

School

Allergies/Health Matters

Permission for child’s name

Permission for child’s photograph

Comment (optional)

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