Players Membership & Registration Form

Players Name *

First

Last

Section/Team *

Date of Birth (dd/mm/yyyy) *

Does the Player have a Medical/Health Condition *

Are you new to the Club, or have you left the Club and returned and require RFU Registration or Transfer to Westcliff Rugby Football Club? *

If you have not formally registered with the Club before, or if you have registered elsewhere and you are returning please tick the Yes box.

Sex *

Add Another Player

Tick Yes to add

Home Address

Primary Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Parent/Guardian and Next of Kin Information

Parent/Guardians Name or Next of Kin *

First

Last

Date of Birth of Parent/Guardian *

DoB for the Parent/Guardian is needed to confirm over 18 year old status to allow voting rights & to complete a mandatory field entry on the RFU Games Management System (GMS) database, which is used to securely store your data.

Phone *

Email *

Membership Subs

Select Membership Required *

Subs are due by the first week of September. If you are having dificulties with payment amounts or payment schedules please contact your manager. All conversations will be kept confidential.

Donation & Gift Aid (Optional)

The Clubs current fund raising drive is for further improvements within and around the clubhouse

Make a Donation *

Total to Pay

£ 0.00

Method of Payment *

Cash and cheques should be given to your Team Manager. Please write the names & teams of players on the reverse side of cheques used to make payments. BACS Transfers are made to : Sort code 30-94-26 and Account: 00026636

Membership Cards

Westcliff RFC is in the process of developing a membership card system that will provide discounts and benefits to members who accept its terms and Conditions. Terms and Conditions for the card can be found below. We would like to highlight that acceptance of the cards Ts&Cs will allow us to contact you to provide details of club promotions, events and any available discounts. This would also allow us to send information from our Club Sponsors to you, which ultimately will help the Club raise funds for our further development. You may, at any time, stop the emails by clicking on the Unsubscribe link at the bottom of the message. All parties involved will adhere to the Clubs Privacy Policy.

Membership Card Terms and Conditions

I wish to receive a Membership Card upon their launch and I agree to the Terms & Conditions *

Yes I/we Agree
No thank you

Declaration/Consent

Medical Treatment *

I give my consent

In the event of injury / illness that may require medical treatment or use of anesthetic I agree to the Team Coach/Manager signing the necessary consent form

Photograph/Video Taking & Publication *

I give my consent

I confirm my consent to photographing/videoing and publication of images of my child whilst participating in rugby activity

Fair Play for All Code of Conduct *

I agree

I have read and agree to follow the club Fair Play for All Code of Conduct Document and, if making the application for a minor, I will ensure that I draw this to the attention of my child.

I certify that all the information is correct and agree to abide by the Laws of the Game, the Club & RFU rules, regulations and disciplinary requirements, which are available on the Clubs website or at www.englandrugby.com/governance *

Club e-News Letter (Optional)

I give my consent

I give my consent for the club to send me "The Westcliff Word", the club e-News Letter via Mail Chimp which contains news, events, and links to sponsors websites. Mail Chimps privacy policy can be found by following the link: https://mailchimp.com/legal/privacy/ the news letter will also be published on the clubs website, and your consent can be removed at any time by selecting the Unsubscribe link on the publication, or by contacting the Clubs Data Officer.

Club Lunch, Dinner and Other Event Notifications (Optional)

I give my consent

I give my consent for the club to send me notifications via e-mail of planned lunches, dinners and other events. Events will also be published on the clubs website, and your consent can be removed at any time by contacting a member of the Clubs Hospitality team.

Signature *

I, the signee, have the authority to sign on behalf of all the Players stated within this submission, and by signing entering into a Volunteer Player (unpaid player) Agreement/Contract as per the terms of this form for the period of 1 year from 1st Sept 2022 until the 31st August 2023 (To sign - Please draw your signature on the touch screen or by using the mouse. When using a mouse, hold down the left button to draw. You can start again by clicking on the x in the top right corner.)

Signees Name *

First

Last

Todays Date *

Captcha *

Please enter your answer in the box above. Please remember "*" is multiply and "/" is divide.