Adult Registration Form Name *Email Address *Phone Number *Address (including Eircode) *0 / 180Date of Birth *Medical conditions or AllergiesYesDo you have any medical conditions including allergies that our Club should be made aware ofDetails including any prescribed medication (name, dosage, frequency).Next of kin / Additional contactIn the case of emergency please give Name and Phone Number of someone club could contactIn the event of an emergency give Gorey Celtic permission to bring to hospital *I consentDo you give Gorey Celtic permission to bring to hospital and to administer medical treatment by suitably qualified person or doctor at the hospital or venue as required.Did you register to play for Gorey Celtic for 22/23 season? *YesNoIf not additional forms maybe required, you will be contacted by your manager if so.Credit / Debit Card *Amount to payCredit / Debit Card Payment *Registration Fee Make Payment / Register
