ࡱ> OQN kbjbj Dhh  8#/d?????>N/P/P/P/P/P/P/24P/"P/??De/??N/N/-@/?P䖬e .:/{/0/..15;p15(/15/ P/P//15 : Player Details Name School Date of BirthAge.Year GroupGender M/F Address ..Postcode Home Tel .Other Tel.. Email. Parents/Carers Names...&. Medical Information Does the participant suffer from any allergies, illness or take any medication? YES/NO (If yes, please give details). e.g. asthma, diabetes, epilepsy. Please also list any other medical details that you feel we should know about. Note: Please ensure that your child brings any medication that they may require to the sessions (e.g. inhaler, travel sickness tablets etc). All medication must be self-administered. Collection of participant Please list the names of all those authorised for the collection of your child / children Do you give permission for your child / children to travel with coaches/managers and other parents in their transport to matches? (Please circle). Yes / No I confirm that my child (print name of young person) is interested in participating in St Ives RFCs development initiative. I can confirm that the information given above is correct and that he/she is available to attend the coaching sessions / sports event. I have completed the medical details and consent that, in the event of illness/accident, any necessary treatment can be administered to my child, which may include the use of anaesthetics. I also understand that while the coaches will take every precaution to ensure that accidents do not happen, they cannot necessarily be held responsible for any loss, damage or injury suffered to my child. I understand that St Ives RFC, their coaches or officials accept no responsibility for loss, damage or injury caused by or during attendance on any Rugby Club activity except where such loss, damage or injury can be shown to result directly from negligence of the Club, its coaches or officials. All parents/guardians should be aware that registered photographers might be present during the activity. In order to create photographic records they may be taking photographs of rugby in action. If you do not wish for your children to be photographed please inform a member of the committee. Signed________________________________ Parent/Guardian ______________________________ Please sign your name here please print your name here     St Ives Rugby Football Club Somersham Road, St Ives, Cambridgeshire. PE27 3LY Tel 01480 464455 ST IVES RFC 2006 V3.0 KM/ANH J / 7 V      3 O 𱨛wooofo^h~)CJaJh5CJaJhCJaJh:CJaJh6CJaJh>*CJaJh5CJaJh5CJaJmHsHh5CJaJ h56CJOJQJ^JaJh:CJOJQJ^JaJhCJOJQJ^JaJ h5>*CJOJQJ^JaJh5CJOJQJ^JaJ IJ  E F } ~ V w   $a$$da$d 6 j k $%o$da$ $ & Fa$gd~) & F & F & F & F & F^o@CEbjk¾¾¾¾{hCJOJQJaJh5CJOJQJh5CJOJQJ&jhCJOJQJUmHnHuh5:CJ OJQJhjhUhCJOJQJaJhCJOJQJ^JaJhCJOJQJ^JaJhCJOJQJ^JaJo@ABCDEbcdefghijk $da$,1h. 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