Membership Form

2013/14 Season

Membership category – please tick one box only / Cost / 
Family Membership* (Non-Playing parent/guardian, with playing children) / £100
Senior Club Playing Member (over 18), with Family Membership* / £150
Senior Club Playing Member (over 18), no playing children / £100
Student(over 18 and in f/t education)/Unemployed Member / £40
Social Membership only / £50
Non- Senior Playing Coach(including discount) / £90
Senior Playing Coach (including discount) / £140
Payment method / 
Cheque attached
Online (date made and reference)
Chip and Pin in the Clubhouse
Bank details
Bank – Barclays Bank
Sort code – 20-88-13
Account name – Tunbridge Wells Rugby Football Club
Account number - 90092657
Reference – name of player and age group

*Family Membership includesany childaged 17 and under, with one subscription covering all children in the same household.

Should the parent/guardian be a Playing Member then the higher subscription (£150) will apply and cover all.

**Coaches discount applies to the ‘children’s element’ only of the above subscription and is conditional upon the coach having the Rugby Ready Qualification eg. Non-Playing parent/guardian and Coach pays £90; Playing Member and Coach, with playing children pays £140. Age limits apply as at 1 September 2013. See attached Membership Fees note for further details.

Principal Member Details (Senior Club member or parent/guardian details)

Name: ……………………………………………………………………………………………………………………………………………………………………………

Address:.………………………………………………..………………………………………………………………………………………………………………………

.……………………………………………..…………………………………………………………………………………………………………………………………………

Contact information

E-mail: 1)…………………………………………………………………….2)……………………………..………….…………………………………......

Telephone: 1)…………………………………………………………….………2)…………………………………………………………………………………….

Mobile: 1)………………………………………………..………………….2)………………………………………………………………………………………

Please complete the following for each Mini/Midi and Junior section player:

Player 1
Surname
First names / M / F
(please delete as appropriate)
Date of birth / Playing Age Group / Under
All players must be registered with the RFU. The Membership Secretary will completethe RFU details below if registered, otherwise please complete the separate RFU registration form.
RFU Registration number / Date RFU Registered
Drs name & surgery
Drs telephone number
School attended
Do you consider yourself to have a disability? / YES / NO
If yes, what is the nature of your disability
Medical conditions
It is an obligation of the club to monitor its membership can you please tick one of the following boxes to identify your ethnic group:
White….. Mixed….. Asian or Asian British….. Black or Black British…..Chinese or other ethnic group.....
Player 2
Surname
First names / M / F
(please delete as appropriate)
Date of birth / Playing Age Group / Under
All players must be registered with the RFU. The Membership Secretary will complete the RFU details below if registered, otherwise please complete the separate RFU registration form.
RFU Registration number / Date RFU Registered
Drs name & surgery
Drs telephone number
School attended
Do you consider yourself to have a disability? / YES / NO
If yes, what is the nature of your disability
Medical conditions
It is an obligation of the club to monitor its membership can you please tick one of the following boxes to identify your ethnic group:
White….. Mixed….. Asian or Asian British….. Black or Black British….. Chinese or other ethnic group.....

(For more than 2 players, please reprint this page, complete and attach)

PHOTOGRAPHIC PERMISSION

I the above parent/guardian do hereby consent/do not consent(please tick as appropriate) to the photographing/videoing and publication of images under the RFU/RFUW’s Policy and Procedures for the Protection of Young People in Rugby Union, and I confirm that I am legally entitled to give consent. In addition I also confirm the player named above is not the subject of a court order.

This consent relates solely to the photographing/videoing and publication of images of the player named above of their involvement in Rugby Union under the RFU/RFUW’s Policy and Procedures for the Welfare of Young People in Rugby Union. Full details of which can be found at

Please sign below to confirm the above details are correct, that you consent to the Photographic Permission above (if appropriate) and also to confirm that you have read the accompanying documents (or at ).
  1. TWRFC Medical and Consent Record
  2. TWRFC General Rules and Codes of Conduct
  3. TWRFC Photographic Policy
  4. TWRFC Safeguarding Policy
  5. TWRFC Membership Fees
Principal Member or Parent/Guardian (name in capitals)………………………………………………………….
Principal Member or Parent/Guardian Signature………………………………………….…Date…………………