Pirates Registration 2020 18yrs+
Please fill in the form below to start your membership with Percy Park Pirates Touch.

If you are under the age of 18 please head to our Youth Registration form. You will also be required to complete a parental consent form which can be found below also.



Contact us at percyparkpiratestouch@gmail.com
Personal Information
Name *
Your answer
Email Address *
Your answer
Mobile Number *
Your answer
Date of Birth *
Your answer
Any Injuries or Medical Conditions? *
Your answer
Experience Level *
Would you like to be added to the WhatsApp Training group? *
Emergency Contact Info
Emergency Contact Name *
Your answer
Emergency Contact Relation *
Your answer
Emergency Contact Phone Number *
Your answer
Do you agree to being filmed and/or photographed whilst at sessions which may be used for publicity purposes? *
Do you agree to the Data Protection Agreement? *
Any information provided on this form will be will be kept secure and confidential in accordance with GDPR. Percy Park Pirates will use the information provided on this form for Coaching and Medical administration and for the purpose of contacting players and parents/guardians regarding the Touch Rugby activity in which they are engaged. In the event of a medical issue or safeguarding concern arising, Percy Park Pirates may disclose certain information to relevant personnel as legally required to do so.
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