ࡱ> AC@g bjbjVV "r<r<\ "ttt$$&:]$]$]$%%%%%%%$T'*%t]$]$]$]$% %e%e%e%]$Rt%e%]$%e%e%R"e%/ws$.e%%%0&e%*$*e%*te% ]$]$e%]$]$]$]$]$%%e%]$]$]$&]$]$]$]$*]$]$]$]$]$]$]$]$]$ :  REGISTRATION FORM - 2011/2012 SEASON BURGESS HILL RUGBY FOOTBALL CLUB COLTS Manager: Mark Stenning, 78 Leylands Rd, B/Hill. RH15 8AJ. Mobile: 07973111992 Data Protection Act 1984 - To facilitate the provision of information and newsletters to our members all details given below will be recorded on a database. This is not used for any other purpose nor will it be so used without your prior consent. Should you have any objection to such a record being maintained you are entitled to request exclusion by writing to the Club Secretary.  (Please complete all sections. One form per player)  Players Name:  Address:  Post Code  D.O.B: Age on 01/09/2011  School the player attends  Home Telephone: Parents Mobile: Players Mobile: ________ Parents / Guardians Email: (Please write this clearly and be aware that we use e-mail as our main form of communication)  Emergency Contact Name (1): Contact Number  Emergency Contact Name (2) Contact Number (You must be contactable on one of these numbers whilst your child is in our care)  Medical Conditions including allergies Medication: (We will administer inhalers with your written permission. Please label with child name.)  Previous Rugby Experience: Please tick the box if you do NOT want your child to have taken or be used in the following: Photo:Video:Internet: Ethic Origin (Tick where appropriate) White: British Mixed: White & Black Caribbean Asian and Asian British: Indian Black or Black British:Caribbean White: Irish Mixed: White & Black African Asian and Asian British: Pakistan Black or Black British: Africa White: Other Mixed: White and Asian Asian and Asian British: Bangladesh Black or Black British: Other Chinese Mixed: Other Asian and Asian British: Other Other Ethnic Group BHRFC Membership 2010/2011: 90 for the season. Additional children in the same family - 10 only (New Players are offered a 2 week free trial) Full payment is required at time of registration. Please contact either the Registration Officer (as detailed on the information board in the clubhouse) or the players coach to discuss any other payment arrangements Payments should be made by either cash or cheque made payable to BHRFC. . Signature of Parent / Guardian:___________________________________ Date: _____/_____/_____ Please read the Junior Club Rules which are displayed on the Information Board in the Clubhouse RFU Registration No: Photo ID: -NTz4 5 6 7 k l | } + , G ` a b c ֵzzzzzzz̀zzee(jh>5U\aJmHnHtH u h>aJ"jh>UaJmHnHtH u h>5h>CJOJQJaJnH tH h>CJOJQJnH tH jh>UmHnHsH uh>CJaJh>5CJaJh>h>5CJaJh>5CJ aJ %jh>5CJ UaJ mHnHu&-NT4 6 7 k m |  * + I $a$ 9r $a$ p^p`$`a$$a$`I J ` b   o v w ~  $Ifc  o v w ~  /013S(\ulee\h>5CJaJ h>5aJh>5>*aJ(jh>5>*UaJmHnHtH u(jh>5U\aJmHnHtH uh>5CJ\aJ,jh>5CJU\aJmHnHtH uh>5CJ\aJh>5>*CJaJ"jh>UaJmHnHtH uh>CJaJ h>aJh>5\aJ /Sgeeeeeee`W$@ ^@ a$$a$kd$$Iflֈp <864 la &'K\qr|}~$a$$a$ p^p`\qr{~h>5CJaJ h>CJh>h>CJOJQJ^JaJt+p,p-p.p1h/R . A!S"S#S$S% 4567w 0+p,p-p.p1h/R . A!S"S#S$S% 4567$$If!vh#v<#v#v#v#v8#v:V l65<555585/ / / / / / / / 4^ 666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH D`D NormalOJQJ_HaJmH sH tH P@P  Heading 1$p@&^p` 5CJaJ(L@L  Heading 2$@&^`5CJDA D Default Paragraph FontVi@V 0 Table Normal :V 44 la (k ( 0No List D@D Header  9r CJOJQJtH >P@>  Body Text 2 CJOJQJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭V$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! I_TS 1?E??ZBΪmU/?~xY'y5g&΋/ɋ>GMGeD3Vq%'#q$8K)fw9:ĵ x}rxwr:\TZaG*y8IjbRc|XŻǿI u3KGnD1NIBs RuK>V.EL+M2#'fi ~V vl{u8zH *:(W☕ ~JTe\O*tHGHY}KNP*ݾ˦TѼ9/#A7qZ$*c?qUnwN%Oi4 =3N)cbJ uV4(Tn 7_?m-ٛ{UBwznʜ"Z xJZp; {/<P;,)''KQk5qpN8KGbe Sd̛\17 pa>SR! 3K4'+rzQ TTIIvt]Kc⫲K#v5+|D~O@%\w_nN[L9KqgVhn R!y+Un;*&/HrT >>\ t=.Tġ S; Z~!P9giCڧ!# B,;X=ۻ,I2UWV9$lk=Aj;{AP79|s*Y;̠[MCۿhf]o{oY=1kyVV5E8Vk+֜\80X4D)!!?*|fv u"xA@T_q64)kڬuV7 t '%;i9s9x,ڎ-45xd8?ǘd/Y|t &LILJ`& -Gt/PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!0C)theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK] ! !$7 " v"c \ I  8B)B@ )A& (  \  3 "? V  # "? 6  "?6  "?6  "?6  "?6  "?6  "?6  "? 6   "?6 ! "? 6 " "? 6 # "? 6 $ "? 6 % "?6 & "?6 ' "?6 ( "?6 ) "?6 , "? 6 - "?#6 . "?$6 / "?'6 0 "?&6 1 "?6 2 "?6 3 "?6 4 "?6 6 "?6 7 "?6 8 "?6 9 "?6 : "?6 ; "?!6 < "?"6 = "?%6 > "?6 ? "?6 @ "?6 A "?B S  ?4k|+`b/012  !L(t<`' t ttHktr tr t$ 5t Dl0tTD0t! !D(0t" !bt$(#<t# <t&K(#t% Kt'Q(t(TX Ht) (*tA%-&t@%y&-t?%&yt>%&t:l t9x-,t8xy,-t7x,yt6x,t4x-,t3xy,-t2x,yt1x,t,8t;l t<l lt-8t.8lt=l _t08_t/8_t\ } $. [ 33,-NS7Vm|+Io \ p r { } >pV\ ^ @ `@UnknownG*Ax Times New Roman5Symbol3. *Cx ArialABook AntiquaACambria Math"hFFYSS20W W KQHX  $PpV2!xx  BURGESS HILL RUGBY FOOTBALL CLUB Simon LashleyBubbaOh+'0h   $ 0 <HPX`$BURGESS HILL RUGBY FOOTBALL CLUBSimon LashleyNormalBubba2Microsoft Office Word@@i@^uw@^uw՜.+,0 hp|  W  !BURGESS HILL RUGBY FOOTBALL CLUB Title  !"#$%&'()*+,-./12345679:;<=>?BRoot Entry FV>wDData 1Table*WordDocument"SummaryInformation(0DocumentSummaryInformation88CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q