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.

Home Address

Parent/Guardian and Next of Kin Information

Membership Subs

Subs are due by the first week of September.

Donation & Gift Aid (Optional)

The Club has decided that Lion Cub membership is free of charge, however if you wish to make a donation to the Club Legacy Fund and claim Gift Aid, you can do so below:
The Clubs current fund raising drive is for the Legacy Fund. The fund will be used to provide security for future rugby player generations by extending the lease of the rugby club grounds and facilities. The current lease runs out in 2045 and we wish to extend this to 2075
£ 0.00

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