PREMIER LEAGUE

APPENDICES YOUTH DEVELOPMENT FORMS
ACADEMY PLAYER REGISTRATION APPLICATION
PLYD Form 5
Endorsement by Parent*
I, (full name) of (address)
Post Code
(and of the above email address) being the person having parental responsibility for the above-named Academy
Player, hereby certify that the above particulars are correct and consent to this application, to the conduct of drug
testing on him in accordance with the Football Association’s Memorandum on Drug Testing and to his receiving
medication as instructed and any emergency dental, medical or surgical treatment, including anaesthetic or blood
transfusion, as considered necessary by the medical authorities present.
Signed Date
Secretary’s Certificate
I hereby certify that I have this day registered (name of Academy Player)
as an Academy Player at the Academy of Football Club
Signed on behalf of the Club
Date
Secretary, the Premier League
§ to be completed if the Academy Player is in age groups Under 9 to Under 16 inclusive and time restrictions apply to the Club’s registration
of Academy Players (see Youth Development Rule 212)
† if the Academy Player last played for a club affiliated to a national association other than the Football Association, unless the Academy
Player is aged under 12 years, this Form must be accompanied by written confirmation from the Football Association that an international
registration transfer certificate has been issued in respect of the Academy Player
* to be completed if the Academy Player is a minor
+ Delete if inapplicable
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