Child Name *

First Name

Last Name

Date of Birth of Child *

Month/Day/ Year

MM

DD

YYYY

Child's Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Parent/Guardian 1 *

First Name

Last Name

Date of Birth of Parent/Guardian 1 *

MM

DD

YYYY

Phone Number for Parent/Guardian 1 *

Country

(###)

###

####

Name of Parent/Guardian 2 *

First Name

Last Name

Phone Number of Parent/Guardian 2 *

Country

(###)

###

####

Name of Emergency Contact *

First Name

Last Name

Phone Number for Emergency Contact *

Country

(###)

###

####

Doctors Name *

First Name

Last Name

Surgery Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Surgery Phone Number *

Country

(###)

###

####

Do you give permission for first aid to be administered in the event of an accident? *

Yes

No

I have read the parent and player policies and will ensure we comply *

You can view: 1. the Parent Policy by clicking here 2. the Player Policy by clicking here

I agree

Do you give consent for your child to have pictures taken by Luton Allstars Football Club for the purpose of official club, media, marketing and promotion only *

Yes

No

Do you give Luton Allstars FC permission to contact you by SMS and email to promote new and existing club initiatives, projects, fee reminders and official club newsletter? *

Yes

No

Registartion can only be completed once the season's fees are paid *

More information about this season's fees and how to make payment can be found on our FAQs page. Click here to see the FAQs page.

I agree and will pay the full sum immediately

I cannot pay the full sum immediately please contact me as i need a payment plan setup

My child is eligible for free school meals:

Yes

No