Wimbledon RFC Minis and Youth Registration Form
PLEASE NOTE: Your Child may NOT be covered by the club's insurance unless the registration has been completed
Players Name
Your answer
Home Phone Number
Your answer
Date of Birth
MM
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DD
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YYYY
Current Address (House number and Street)
Your answer
Current Address (Town)
Your answer
Current Address (Post Code)
Your answer
AGE GROUP / Playing Section
School Attending
Your answer
Mother's Name
Your answer
Mother's Email
Your answer
Mother's Mobile Number
Your answer
Father's Name
Your answer
Father's Email
Your answer
Father's Mobile Number
Your answer
Agreement Declaration
I confirm that I have been advised of the existence of the Club’s Child Protection Policy (available to view on the Club’s website or in hard copy on request) and that I accept the above named child will participate in Club activities subject to the terms of that Policy. I agree and accept that photographic and video images may be taken of the above named child during the normal course of rugby activity, by accredited press photographers and/ or other parents and the images may be used in the local press or in club publicity, in line with RFU guidelines for the welfare of young people in Rugby Union. I confirm that I am legally entitled to give this consent. I consent under the Data Protection Act to the Club using the above data for all purposes associated with administering the Club including its sporting, social and fundraising activities. The data may be kept by the Club on a database provided by the RFU, as well as by the individual age group management, and will not be made available to any other person.
Required
Medical Conditions, Allergies - Any other information for coaches to know
(N/A is none)
Your answer
SUBSCRIPTION (Early Bird -10% if Paid Before 24th September 2017
Payments made by:Cash / Online* (www.wimbledonrfc.co.uk/payments) / Credit/Debit card (delete as appropriate) *Lloyds TSB, Sort Code: 309966, AC No: 01419354, AC Name: WMRFC
Required
Confirmation of Payment method
Required
Date of Registration & Payment
MM
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DD
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YYYY
Submit
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