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Mini/Midi/Youth Reg Form PDF Print E-mail
 

 THAMES RUGBY UNION

   logo.png 

  FOOTBALL CLUB

   Mini's, Midi's, Youth
 &
 Colts Registration Form
 

Name:

Male/Female 

Date of Birth:   

Address:

   

Post Code   

Home Telephone No:   

Mobile Telephone No:   

Email

Dr's Name & Address:


 

Please tell us about any medical conditions (including allergies) & Medication that you are taking: 

  

School Name & Address:


 

Mother's Name

     

Father's Name

     

Player's Signature: 

Parents/Guardians Signature:

Date: 

Date:

Membership Fee Paid:

     

Amount Paid:     £        :       .

     

Membership Card Issued