BANGOR RFC MINI RUGBY REGISTRATION FORM 2017/18

• Registration will be held in the club house before training starts for the first 3 weeks of the season.

• Returning players will not be permitted to participate beyond the 10th September if their subscription has not been paid.

• Please complete the form and return with payment to ensure that your place is reserved.

PLEASE PRINT ALL INFORMATION ON THIS FORM FULL
NAME OF MINI RUGBY APPLICANT / DOB / AGE AT 01.07.2017
SCHOOL ATTENDED / SCHOOL YEAR FROM SEPTEMBER 2017
NAME OF PARENT/GUARDIAN
FULL POSTAL ADDRESS (inc postcode)
E-MAIL (this will be used as the main means of contact)
HOME TELEPHONE / MOBILE
EMERGENCY CONTACT NAME / RELATIONSHIP TO PLAYER
EMERGENCY HOME TELEPHONE / EMERGENCY MOBILE
DETAILS OF ANY ALLERGIES OR MEDICAL CONDITIONS
DETAILS OF FAMILY DOCTOR (Name and Health Centre/Hospital)
PHOTOGRAPHY DECLARATION I hereby give permission for any photographs taken of the above child during coaching sessions, inter-club fixtures, Festivals or in conjunction with sponsors, to be used for press and promotional purposes.
SIGNATURE
CODE OF ETHICS DECLARATION I hereby declare that I will abide by the IRFU Code of Ethics for spectators at all mini rugby events. The Code is available to view or download from www.bangorrfc.co.uk
SIGNATURE
HELPING WITH MINI RUGBY Please circle if you would be interested in helping out at BRFC Mini Rugby.
Coaching / Organising / Sponsorship / Communication / Catering
CLUB MEMBERSHIP Please tick if you would like information about joining Bangor RFC as a non-playing member.
Yes / No
• MINI RUGBY FEE FOR 2017/18 SEASON IS £80.00 PER PLAYER.
• FEE PER ADDITIONAL PLAYER FROM THE SAME FAMILY IS £60.00 (Each child needs a separate form submitted).
• PLEASE MAKE CHEQUE PAYABLE TO BANGOR RFC AND PLACE YOUR CHILD’S NAME ON THE REVERSE.