TACKLE Rugby 2019
Details for TACKLE Rugby Camp 2019 hosted by Stirling County RFC

Please complete a seperate form for each child attending.

Players Name *
Your answer
Players Age *
Your answer
Players Date of Birth *
Please enter as: DD/MM/YYYY (I.e. 25/10/2000)
Your answer
Players School Year (2018 - 2019) *
(P4, P5, P6, P7, S1 or S2)
Your answer
Address (line 1) *
Your answer
Address (line 2)
Your answer
City *
Your answer
Postcode *
Your answer
Contact Telephone Number (mobile preferred) *
Your answer
Contact Email Address *
Your answer
Emergency Contact 1 - Name *
Your answer
Emergency Contact 1 - Telephone *
Your answer
Emergency Contact 2 - Name *
Your answer
Emergency Contact 2 - Telephone *
Your answer
Previous Rugby Experience *
Number of seasons played.
Your answer
Currently Taking Any Medication *
(Add details in Medical Section)
Medical Conditions / Injury History / Player Welfare Issues *
Please mark as N/A if no Medical Conditions or history of major injury is present. Player welfare issues cover anything that may be relevant as we care for your child over an extended period of time whilst they are interacting as part of a large group. This information is confidential to the coaching group.
Your answer
T-Shirt Size *
Small Junior / Medium Junior / Large Junior / Small Adult / Medium Adult / Large Adult
Your answer
Permission for photographs *
On-Line payment can be made via Bank Transfer. Payments must be accompanied by an email to: tacklerugby@outlook.com
Bank Transfer to:
Bank of Scotland, Sort Code: 809129, Account Number: 01575621
With reference: TACKLESurname with online registration (i.e. TACKLEStirling)
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