/ Exmouth Rugby Football Club Limited
Membership Renewal/Application
2015 / 2016 / Membership No.

All Applicants Membership Information

Principle Name:
(Parent/Guardian for Junior Playing Member) / Mobile:
Email Address: (Please print clearly)
Spouse/Partner’s Name: / Mobile:
Email Address: (Please print clearly)
Home Telephone: / Post Code:
Address: / Car Reg 1:
Car Reg 2:
(Fee applies unless a VP)

Club Membership

Vice President **Free Match Day Entry applies
Voting member, 2 Car Park Passes, *Inc. 1 Junior Player’s membership / £130.00 each
Full Member **Free Match Day Entry applies
Voting member, 1 Car Park Pass, *Inc. 1 Junior Player’s membership / £85.00each
Senior Playing Membership **Free Match Day Entry applies
Voting member, 1 Car Park Pass, *Inc. 1 Junior Player’s membership / £100.00 each
Social Member
Non-voting member and 1 Car Park Pass / £70.00 each
Junior Playing Family Membership **Free Match Day Entry applies
Non-voting member, 1 Car Park Pass, *Inc. 1 Junior Player’s membership / £80.00 each
Additional Junior Playing Membership
(Junior player must be 17 or younger on 1st September 2015) / Number of additional players / £30.00 each
Additional Car Parking Permit (maximum of 2 cars per member) / £40.00 each
*Note 1:Junior players must be 17 or younger on 1stSeptember 2015and membership includes one pair of ERFC playing socks per player, free of charge.
**Note 2:Free match day entry is only for league games and excludes all cup and league play offs. A valid membership card must be shown at the gate. This concession is subject to review by the Board of Directors. / Total £

Please complete the membership forms, signed and return with the remittance (unless paying by BACS or Standing Order) to:

Chris Witkiss, Membership Secretary at: 17 Seymour Road, Exmouth, Devon, EX8 3JG.

Please note that membership cards and car permits will not be issued until full payment has been received, unless paying by standing order.

ERFC has a policy to update the membership on ERFC & RFU matters. Your personal details will not be passed to any third parties.

Exmouth Rugby Football Club LimitedRegistered Address: Exmouth RFC, Royal Avenue, Exmouth, Devon. EX8 1DGTel: 01395 263 665

Company Registration No. 07460939VAT Registration No. 142 153 407V5– 150708

Junior Player Information
Player 1 / Name : / DOB : / / / Gender :
Player 2 / Name : / DOB : / / / Gender :
Player 3 / Name : / DOB : / / / Gender :
Player 4 / Name : / DOB : / / / Gender :
Photography (Junior Rugby ONLY)
At times your child may be photographed by journalists or others, whilst playing rugby, for the inclusion in match reports or similar, or for team photographs during the season. Please indicate if you do or do not object to your child being photographed.

I consent for my child to be photographed:

I do not consent for my child to be photographed:
Payment Details
Please indicate which method of payment you have chosen to use;

Cheque Payable to ‘Exmouth Rugby Football Club’.

Cash

Electronic (BACS) Account Name : Exmouth RFC, Sort Code: 600809, Account No: 72315857

Standing Order Start date: / / Last date: / / (ERFC Standing Order Form is available upon request)
Account Name : Exmouth RFC, Sort Code: 600809, Account No: 72315857
When paying electronically please enter your name (e.g. Chris Witkiss) in the Bank’s reference field
Club Rules and Code Of Conduct (All Members)
The following Rules, Articles, Codes and Policies are available on the club website;
Codes of Conduct
Policies Documents
Rules of Exmouth Rugby Football Club Limited
Website Address :

Subject to the Memorandum and articles of the above named Company (“the Company”), to any rules for the time being made there under, and to any terms for membership applicable to the Company, application is made by the above signed for voting membership of the Company and in the event of the Company being wound up while the above signed is a member, or within one year afterwards, the above signed undertakes to contribute such amount as may be required not exceeding the guaranteed sum of one pound (£1), for payment of the debts and liabilities of the Company.

**Free Match Day Entry concession is subject to review by the Board of Directors.

All renewals and new applications for membership of Exmouth RFC are subject to the approval of the Board of Directors.

By signing this Membership Application you agree to abide by the Rules, Codes of Conduct and Policies of Exmouth Rugby Football Club Limited.

Signed: ______Date: ______

Exmouth Rugby Football Club Limited

Registered Address: Exmouth RFC, Royal Avenue, Exmouth, Devon. EX8 1DGTel: 01395 263 665

Company Registration No. 07460939VAT Registration No. 142 153 407V5 - 150708

For Office Use:

Received:Approved:Card Issued:Car Park Pass Issued: