WITNEY RUGBY FOOTBALL CLUB
MINI AND JUNIOR SECTION
Youth Registration Form
Please complete form in Capitals
PLAYER DETAILS RFU No
First Name Surname
Date of Birth Age Group Under
Details of All Known
PARENT / GUARDIAN DETAILS
I / We give my / our permission for the above named player to train / play for Witney Rugby Football Club.
First name: Surname:
Tel: (Home) Tel: (Mob)
Parent / Guardian Tel: Tel:
(2) Name (Home) (Mob) :
I declare that the above information is correct. In signing this form I agree that the above named player can be bound by the
laws and resolutions of the RFU and its Constituent Bodies and the rules of Witney Rugby Football Club.
I also agree to participate in my Childs’ age group match management duties.
Signature of Parent
Name of School Name of PE Teacher
Wolves U7-U8 U9-U12 U13-Colts Cherubs 4 Child Post Xmas Total
£45 £45 £55 £65 £65 Free £30 Cost
MEMBERSHIP FEES MUST BE PAID BEFORE PLAYING IN ANY GAME, LEAGUE, FRIENDLY OR TOURNAMENT
For all NEW PLAYERS and PLAYERS REACHING JUNIOR STATUS (U13) 2 recent passport size photos with the players’ name
on the reverse of each photo is required along with a completed RFU Registration Form.
MEMBERSHIP FEE IS NON REFUNDABLE
Please make cheques payable to Witney Rugby Football Club
Data Protection Act. The information contained above will be held for registration and membership purposes only, and will not be made available to any person outside
the RFU without prior consent. You may request to see any personal information stored on a computer.
I confirm that I have received and read the Mini and Junior Handbook
Please return the completed form to the Mini and Junior Membership Secretary
Simon Burnell :- Sunny View, 9 Witney Lane, Leafield, Witney, OXON OX29 9PS
Or hand to your Age Group Rep.
OFFICIAL USE ONLY
CHEQUE CASH RFU FORM PHOTOS DATE PROCESSED
MJ001 ISSUE 9.0 110605