Membership Applications
The information you provide will be held for registration and membership purposes only, and will not be made available to any person outside the Club, RFU or ETA without your prior consent. You may request to see any personal information we hold about you. Online payment instructions follow on submission of this form.
Membership applied for *
The membership fee applicable is shown at the top of this page
First Name *
Your answer
Surname *
Your answer
Sex *
Date of Birth
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Email address
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Contact telephone number *
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Address
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Postcode
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Please provide details of any medical conditions from which you are suffering
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Please provide details of any allergies from which you are suffering
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Please provide details of any medication that you are currently using
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Person to contact in case of an emergency *
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Emergency contact's phone number *
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Agreement *
I apply for membership of Gosford All Blacks RFC (“the Company”) and agree to be bound by the Articles of Association of the Company and any Rules and Policies made pursuant thereto. I understand that the liability of each member is limited to £1, being the amount that each member undertakes to contribute to the assets of the Company in the event of its being wound up while they are a member or within one year after they cease to be a member.
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