ࡱ> CEB l bjbjVV .4<<lEEEEEYYYYuYCJJJ$;EJ("JJJEEJ:EEJ`U_Y 0CE JJJJJJJJJJCJJJJJJJJJJJJJ : PULBOROUGH RUGBY CLUB MINIS SECTION: Season 2011/12 Tel: 01903 746461 60 Hormare Cresecent Mobile: 07763 916990 Storrington E-Mail: akerslj@googlemail.com West Sussex Web:  HYPERLINK "http://www.pitchero.com/clubs/pulborough" http://www.pitchero.com/clubs/pulborough RH20 4QX  Players Surname: Players Forename: Date of Birth: Age Group: Under (as at 1st September 2011)Address: Post Code: Home Tel: Mobile Tel: E-mail: School Name & Address: Doctors Name & Address: Disabilities & Allergies: Parents Names: PRFC Membership No: Previous Club if Any:RFU Reg. Number: As a player I declare that the above information is correct. In signing this form I agree to be bound by the laws and resolution of the Rugby Football Union and its Constituent Bodies and the rules of Pulborough Rugby Football Club Signed (player)Date As a parent I consent to any emergency medical treatment necessary during the course of Pulborough Rugby Club activities Signed (Parent/Guardian)Date Data Protection: The information contained above will be held for registration purposes only and will not be made available to any person outside the Rugby Football Union 789o   " $ % [ \ ] ̻|a|Ca/a&he0J56CJOJQJ\]^J:jhe56B*CJOJQJU\]^Jph4jhe56B*CJOJQJU\]^Jph+he56B*CJOJQJ\]^Jph+he56B*CJOJQJ\]^Jph$he56B*CJOJQJ\ph!he56B*CJOJQJph!he56B*CJOJQJph heCJhe56CJOJQJ heCJhe heCJ79o $$Ifa$$If$a$     # * + 6 : ; E I J V Z [ c g h       # $ ˿ heCJ he5 heCJH* heCJ he5\heCJaJ heCJhehe5>*CJ \aJ he5CJ \aJ heCJ jheUhe56\]"he56CJOJQJ\]^J8  f]]]WQK$If$If$If $$Ifa$kd1$$Ifl\k   0644 la  # % & ( * f]]]]] $$Ifa$kd$$Ifl\k   0644 la* + 6 8 : $$Ifa$rkd$$Ifl0 0644 la: ; E G I $$Ifa$rkdW$$Ifl0 0644 laI J V X Z $$Ifa$rkd$$Ifl0 0644 laZ [ c e g $$Ifa$rkd$$Ifl0 0644 lag h t  $$Ifa$rkd%$$Ifl0 0644 la $$Ifa$rkd$$Ifl0 0644 la $$Ifa$rkdY$$Ifl0 0644 la }$If $$Ifa$rkd$$Ifl0 0644 la     f]]W]$If $$Ifa$kd$$Ifl\ 0644 la     ! 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