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020 7650 1200

Your details

This form should take no more than 5 minutes to complete. We will ask you to provide some contact details, information about the ticket you purchased and the injuries you suffered.

If you are signing up on behalf of someone under the age of 18, please inform us using the dropdown menu. Please note, you must have the authority to sign up on behalf of the minor. Please see our FAQs for more information.

* indicates field is compulsory.

Please give your full name - for example Daniel not Dan
Please enter at least two letters

From here, please complete the form as if you are the minor (except where stated otherwise). Put your child's details in the rest of the form and complete a form for each child.

Please enter your postcode to find your address
Or enter your address manually
Please ensure there are no spaces within or after your email address. If you are completing this form on behalf of someone under 18 please provide your email address.
Please ensure there are no spaces between numbers and that you add a valid phone number so we can contact you if necessary. If you are completing this form on behalf of someone under 18 please provide your telephone number.
The LFC membership number is 8 digits, and is the same as your Supporter ID. The UEFA reference is 9 digits.
Please provide brief details
Please provide brief details
Please include any other information that you think might be useful.

We treat all information in accordance with our privacy policy.