PREMIER LEAGUE

APPENDICES YOUTH DEVELOPMENT FORMS
PREMIER LEAGUE
PLYD Form 2
NOTIFICATION OF TRIALIST’S PARTICULARS (Youth Development Rule 213.2)
To: The Secretary
The Premier League
We hereby give notice that the Trialist whose particulars appear below is attending the Academy of
Surname Other name(s)
Address
Post Code
Football Club:
Parents’ email address
Travelling time from this address to the Academy #
Date of Birth Place of Birth Nationality
Date of commencement of trial period
Date trial period is due to end §
Other clubs (if any) at whose Academy the Trialist has attended for a trial during the current Season
Other clubs (if any) at whose Academy the Trialist has been registered:
Club From To
Club From To
Endorsement by Parent +
I, (full name) of (address)
Post Code
being the Parent (as defined in Youth Development Rule 1.42) of the above-named Trialist, 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. I further consent pursuant to Schedule 2 and Schedule 3 of the Data Protection
Act 1998 to The Football Association Premier League Limited holding and processing any and all “personal data” and
“sensitive personal data” relating to the above-named Trialist contained within this Form 24 for the purpose of
discharging its functions as a regulatory and governing body of football. I further certify that I have provided to the
above-named Club full written particulars of any medical condition from which the above-named Trialist suffers and
I undertake to inform the Club forthwith in writing if any such medical condition arises during the trial period.
Signed by the Parent Date
Countersigned by the Trialist Date
Signed on behalf of the Club Position Date
# to be completed if the Trialist is in age groups Under 9 to Under 14 inclusive (subject to the exception in Youth Development Rule 214.2)
§ not more than 6 consecutive weeks from the date of commencement
+ to be completed if the Trialist is a minor
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