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Membership Form - Minis & Juniors
Cranleigh Rugby Football Club
Mini & Junior Section
Registration/Renewal Form
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Player member's full name:
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Date of birth:
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Age group - Under
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Address including postcode:
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School:
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RFU Reg. number:
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How did you hear about us?
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Parent/Guardian first names:
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Email:
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Home Phone:
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Mobile:
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Would you be prepared to help at the club?
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Occupation
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Medical conditions or allergies: (Please detail below any important medical information that our coaches/junior coordinator should be aware of (e.g. epilepsy, asthma, diabetes, etc.)
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Annual Subscriptions
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There is a £10 discount applicable to all second & subsequent sibling players.
Payment of membership & submission of this form entitles the named player to train and play with Cranleigh RFC. For Juniors, this includes midweek as well as Sunday sessions. Free food will normally be provided after home matches.
Please make cheques payable to Cranleigh RFC Junior Section.
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Category
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All-In Fee
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U7 to U8
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£40
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U9 to U12
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£45
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Juniors
U13 to U18
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£65
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Family
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+£15
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Entitles you to apply for International Tickets
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DECLARATION:
I would like my son/daughter to join the rugby sessions organised by Cranleigh RFC. I understand that, whilst great care is taken to maintain the highest standards of safety during coaching sessions and matches, Cranleigh RFC or any of its members can accept no liability for any loss of property, accidents or injuries, of or to my son/daughter, howsoever caused. I understand that the Mini/Junior section has insurance cover under the R.F.U. Scheme for the club and its members for claims arising from accidents causing disability or death. However, it is recommended by Cranleigh RFC that additional individual accident cover be obtained. I understand that if my child is playing up an age group then I will need to arrange my own insurance. I declare that the information on this form is correct and agree that the above named player will be bound by the codes of conduct of Cranleigh RFC.
For insurance reasons, fees must be paid before a player may play.
MEDICAL CONSENT DETAILS:
I agree that if my son/daughter urgently requires medical treatment during a Cranleigh RFC activity and it is not possible to contact a parent/guardian, the person in charge of the party is authorised to give consent on my behalf.
NAME OF FAMILY DOCTOR:__________________________ Tel____________________
CHILD PROTECTION:
Cranleigh RFC's Policy is in line with that recommended by the Rugby Football Union. A full copy of the document is available on request from the Child Welfare Officer Shelia Gibson, Tel: 01483 275524
PHOTOGRAPHY:
I give my consent to the taking and publication of photographic images, taken by persons appointed by Cranleigh RFC for publicity/coaching purposes (including publication on the club web site, local newspapers, etc) unless I have provided a separate letter of objection to Cranleigh RFC's Child Welfare Officer.
TRAVEL PERMISSIONS:
I give permission for my son/daughter to travel with either the Coach or another adult and I realise that I must take full responsibility for his/her behaviour.
DATA PROTECTION:
I acknowledge that I am aware of the purpose for which this personal data is required and understand that it will be held in the strictest confidence and I consent to this data being held on a database for exclusive use of the Club. (Please note that the Club would prefer the data to be held electronically for the ease of administration).
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Signed (Parent/Guardian):
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Date:
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Payment received:
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Receipt No:
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Please return this form to Samantha Graycon, Ranfold Farmhouse, Five Oaks Road, Slinfold, West Sussex RH13 0RL
Tel 01403 790156
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