EAST KILBRIDE RUGBY ACADEMY

East Kilbride Sports Club,

Strathaven Road,

Calderglen,

East Kilbride. G75 0QZ

Academy Membership Details for Season 2016 - 2017

(Incorporating Mini and Midi Sections)

Welcome to an adventure packed season with the Rugby Academy at East Kilbride.

Membership is paid as a yearly fee as laid out below. Alternatively the amount can be paid by monthly standing order throughout the year.

There are 3 categories within which a player may become a member. Please ensure you pick the correct one. If you have any doubt at all please contact any member of the coaching team.

Category / Membership Fee / Monthly Standing Order / Details of Category
Youth Player / £180.00 / £15.00 / Youth players – U18
Coach & 1 player
Coach & 2 players / £270.00
£450.00 / £22.50
£37.50 / Academy Coach & 1 youth players
Academy Coach & 2 youth players
Family membership
2 Adults & 1player
2 Adult & 2 players / £300.00
£456.00 / £25.00
£38.00 / 2 Adults & 1 U18 child/player
2 Adults & 2 U18 children/players

Membership is for a full year and is not reduced if a player decides to leave. The responsibility for payment lies with the parent / guardian of the player and no refunds are given.

You will find attached the following forms:-

Membership Form (1 page) – new members and members whose details have changed please complete & return to any Coach.

Safe in Care Form (2 pages) - All members (new & existing) to complete & return to any Coach.

Standing Order Mandate (1 page) – All members (new & existing) please complete & hand in to your bank as soon as possible to allow for the first payment. Or set up online.

NB When completing the standard order form please ensure the first payment date is at least 5 days in advance of the date you submit the form to your bank.

Thank you & here’s to another year of fun enjoyable Rugby

David Eadie

Academy Convenor

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MEMBERSHIP FORM

EAST KILBRIDE RUGBY FOOTBALL

RUGBY ACADEMY

Playing Year 2016/2017

Players Name ...... Date of Birth ......

Address ......

...... Post Code ......

Telephone Number: Home ...... Email Address: ………………………………………………….

1st Mobile ...... Name ...... Relation to player ......

2nd Mobile ...... Name ...... Relation to player ......

School ...... School Year ......

Is your child already a member of East Kilbride Sports Club/Rugby Club? YES/NO

MEMBERSHIPS: (Please tick box appropriate to player)

Category Monthly Details of Category

Standing Order

Junior Player / £15.00 / Youth player/s – U18
Coach & 1 player
Coach & 2 players / £22.50
£37.50 / Academy Coach & 1 youth players – U18
Academy Coach & 2 youth players – U18
Family membership
2 Adults & 1player
2 Adult & 2 players / £25.00
£38.00 / 2 Adults & 1 child/player – U18
2 Adults & 2 children/players – U18

Note: Membership entitles the member or the parents to purchase a season ticket for East Kilbride

Rugby Football Club 1st team home league games and free entry into national Cup games.

Please Complete (Please tick boxes to confirm):-

I confirm having forwarded the Standing Order Mandate to my Bank. / set up online.

I agree to ensure that my son/daughter/ward shall abide by the rules of the Club and uphold the constitution.

I enclose herewith a completed copy of the safe in care form.

I consent to the information submitted on the form being held and reproduced, as appropriate, by EKRFC.

Signature of Parent/Guardian ......

Name (Capitals) ...... Date: ......

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FORM 9: SAFE IN CARE- EKRFC PARTNERSHIP WITH PARENTS

Name of Player : ______Age Group : ______

EKRFC values the involvement of children in our sport. We are committed to ensuring that all children have fun and stay safe whilst participating in rugby.

To help us fulfil our joint responsibilities for keeping children safe EKRFC has introduced Safe in Care Guidelines. These Guidelines tell you what you can expect from us when your child participates in rugby and details the information we need from you to help us keep your child safe.

We need you to you complete this form at the start of every season and to let us know as soon as possible if any of the information changes. All information will be treated with sensitivity, respect and will only be shared with those who need to know e.g. a team manager or first aider.

A.  TRANSPORTATION OF CHILDREN

I consent / I do not consent* (*delete as appropriate) to my child being transported by persons representing EKRFC or one of its individual members or affiliated clubs for the purposes of taking part in rugby.

I understand EKRFC will ask any person using a private vehicle to declare that they are properly licensed and insured and, in the case of a person who cannot so declare, will not permit that individual to transport children.

Signed : ______Date ______

B.  PHOTOGRAPHS AND PUBLICATIONS (INCLUDING WEBSITE)

Your child may be photographed or filmed when participating in rugby. All reasonable steps will be taken to obtain parental consent In the absence of any explicit objection, those responsible will act in the best interests of the child which may include assuming parental agreement for the above reasons.

I give / I do not give* (*delete as appropriate) my permission for my child to be involved in photographing/filming and for information about my child to be used for the purposes stated in EKRFC Safe in Care Guidelines.

Signed : ______Date ______

C. SAFE IN CARE GUIDELINES

I am aware of the Safe in Care Guidelines for rugby and agree to work in partnership with EKRFC to promote my child’s safe participation in rugby.

I understand EKRFC will listen to the views of my child in relation to all matters affecting them and require to respect my child’s ability to give their own informed consent.

Parent/Guardian’s Name: ______

Parent/Guardian’s Signature: ______Date ______

EKRFC Representative’s Name: ______

EKRFC Representative’s Signature: ______Date ______

Page 2 of 2

FORM 9: SAFE IN CARE- Continued

D.  MEDICAL INFORMATION and CONSENT

Name of Player : ______

Age Group : ______

Name of General

Practitioner (GP) ______

Address of GP ______

______

______

Telephone Number of GP ______

Please complete the following details. If none, please state “none”.

1.  Any pre-existing medical conditions that may affect the child’s participation in rugby:

2.  Any medication or treatment required:

3.  Any existing injuries (include when injury sustained and treatment received):

4.  Allergies, including allergies to medication:

I consent to my child receiving medical treatment, including anaesthetic, which the medical professionals present consider necessary.

I undertake to inform EKRFC should any of the information contained in this form change.

Parent/Guardian’s Name: ______

Parent/Guardian’s Signature: ______Date ______

Page 1 of 1

Standing Order Mandate

East Kilbride Rugby Academy

Please pass this form to your bank after completion

To: / The Manager
Postal address:
(your bank branch & Address) / Branch : ______
Address : ______
______
______
______
______
Please pay: / The Royal Bank of Scotland
24-25, Princes Square,
East Kilbride,
Glasgow.G74 1LJ
For the credit of: / East Kilbride Mini Rugby Club

Account Number 00685984

Sort Code 83-28-13
First Payment to be made on 1st August 2016 / £
Amount every 5th day of the month thereafter: / £__ . __
Please debit my account accordingly:-
Reference to be used to identify member
(Players Name) / ______
Name of Account to be debited: / ______
Your Account number: / ¦___¦___¦___¦___¦___¦___¦___¦___¦
Your Sort code:
/ ______:______:______

Signature: ______Date:______

This Standing Order Mandate supersedes all previous standing orders to East Kilbride Mini Rugby Club