Seniors - Rhyl Rugby Club

Player Details:

Player Name *

First

Last

Senior Section *

Senior Men
Senior Ladies

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Date of Birth *

Email *

Email

Confirm Email

Emergency Contact Details:

Emergency Contact Name *

First

Last

Phone number *

Alternative Contact Name *

First

Last

Alternative Contact Number *

Does the Player have a pre-existing medical condition or allergy the Club should know about? *

Yes
No

Please tick this box if you would like to discuss a medical condition confidentially and the Club Safe Guarding Officer or other appropriate Club Official will contact you privately.

Yes

Medical Condition: further information

I hereby grant permission to be photographed or filmed regarding their involvement in rugby union for the purposes of:

Coaching/video analysis and the promotion of Rhyl RFC, in press releases and publications, both online and in other forms of public communications eg. Local press

Marketing Emails

I do not wish to receive marketing emails from Rhyl Rugby Club

Senior Membership

Price: £85.00

Per Season

Payment Details *