WHITSTABLE RUGBY FOOTBALL CLUB by Z4LC6pQ

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									                         WHITSTABLE RUGBY FOOTBALL CLUB
                                Ground and Clubhouse
                    Reeves Way, Chestfield, Whitstable KENT CT5 3QS
                              Telephone 01227 794343
                           Website at whitstablerugby.co.uk
Senior Section
Membership Secretary:
Cameron Hatten, 14 Share & Coulter Rd. Chestfield Whitstable CT5 3LE Mobile 07801 716256

                           Membership Application Form 2011/2012 Season
Surname                                                 Christian
                                                        Names
Home Address &
Post Code
E-Mail address

Home Tel No                                                    Mobile No

Date of Birth                                                  Town of Birth

Emergency                                                      Rugby Club played
Contact Name                                                   for last season
& Number
Medical Info                                                   Playing Position


                        Annual Subscription Fees for 2011/2012 Season
Please tick relevant box and enclose payment with this form. Cheques to be made payable to
Whitstable RFC and returned to Membership Secretary (details above) by no later than 30th Sept 2011

Membership type                      Cost    Tick    Description

Player Membership Family             £85 /           Use of Club Facilities to whole family
                                     £75*
Player Membership Single             £80 /           Use of Club Facilities to player only
                                     £70*
Player Membership                    £45 /           Use of Club Facilities to player only
Student/Apprentice – over 21         £35*
21 years and Under Membership        £30 /           Use of Club facilities to player only
                                     £25*
VP Membership Single                 £35             Use of Club Facilities to VP only

Social Membership Single             £5              Use of Bar Facilities to member only

Social Membership Family             £10             Use of Bar Facilities to whole family

* Lower cost applicable if fully paid by 30th September 2011.
Higher cost applies if payment remains outstanding by 1st October 2011.
□     Tick here if you do not wish to receive advertising literature from club contacts


Signed…………………………………………………………… Date……………………………………………………...

Print Name ……………………………………………………

Club use only
Amount Received £ ………………………………………… Date ………………………………. Cash/Cheque

Signed ……………………………………………………………

RFU Registration Form Sent …………………………….. Form Returned …………………………………….


                                                                               Form last updated Jun 2010

								
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