MEMBER'S POLICY. The Football Mutual Insurance Federation. RESIDENT SECRETARIES:- THOS. CHARNLEY, WM. MACANDREW, Solicitor, N. WHITTAKER, 47 Tithebarn Street, Preston. 227 West George Street, Glasgow. 52 Beecroft Road, Brockley, London, S.E. ________________ Policy No. ................ SPECIMEN. Whereas The______________________________________________________________________________________________________________________ _________________________________________________________________________________________________________________________________________ (hereinafter called "the Member") has been admitted a Member of The Football Mutual Insurance Federation (hereinafter called "the Federation") for the purpose of securing indemnity against the liabilities referred to in the Rules and Conditions hereinafter mentioned in respect of the players and trainers named in the Schedule annexed hereto, and as such has become bound to pay the entry fee and such levies, if any, as may be made in terms of said Rules. Now it is hereby Agreed (subject to the Rules of the Federation and the Conditions on the back hereof, which are to be taken as part of and incorporated in this Policy) as follows:— I. In the event of any accident to a player or trainer specified in the Schedule hereto annexed arising out of and in the course of his employment whilst engaged in the service of the Member, during the currency of Membership, causing death or partial or total disablement, the Federation will indemnify the Member against liability under the "Workmen's Compensation Act, 1906," to such extent, and that only, as is specially provided for by the Federation's Rules. II. The commencement of the Federation's Liability to indemnify the Member as aforesaid in respect of each player or trainer shall be the date inserted opposite each player or trainer's name in the second column of said Schedule, but shall only operate to the extent set forth in the said Rules. In witness whereof this Policy has been signed on behalf of the Federation by a Director and a Resident Secretary on the _____________________________day of___________________, Nineteen hundred and_____________________ _______________________________________Director. _______________________________Resident Secretary. SCHEDULE REFERRED TO IN POLICY. Name and Address of Player or Trainer Insured. Date of Remarks. Name and Address of Player or Trainer Insured. Date of Remarks. Commencement of Commencement of Liability. Liability.