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WELCOME TO HIGHWORTH TOWN

WALKING FOOTBALL CLUB

REGISTER

Member Application and Consent Form

Please fill in all fields to register to play at any Highworth Town walking football club sessions.

First Name

Last Name

Email

Phone

Date of Birth

Street Address

City

Post Code

Emergency Contact Name

Emergency Contact Phone

Optional medical information needed in emergency:

Have you played or ever been registered at any other Wiltshire based WF Session?

I confirm that the above information is accurate and agree to notify the club secretary of any changes immediately.

I agree to abide to the clubs rules & regulations. View Club Rules

Thanks for registering.

© 2023 Highworth Town Walking Football Club.

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