top of page

Undy AFC Medical Declaration

All registered senior players (1st, 2nds, 3rds, U19s, Women & Saturday Ladies) need to complete the following medical declaration as part of your registration with the Club.  Your registration will not be processed unless this form has been completed.  For further information, please contact Gemma Martin via


Player Details

Emergency Contacts

Medical Details

Note: It is the responsibility of the player, or if the player is under 18 their parent/guardian, to notify the club of any changes to this declaration and by completing this form you give consent for the appointed first aider to administer basic first aid or to take whatever action deemed appropriate in an emergency situation. This form will be retained by the team coaches for reference during matches and training sessions.  The completed forms will be stored in accordance with the Club's GDPR guidelines, for further information please contact

Thanks for choosing Undy AFC! Our team will now process your form and contact you if any further information is needed.

This form no longer accepts submissions.

bottom of page