|
THAMES RUGBY UNION
|
|
|
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
|
|
|
|
|