ࡱ> g gbjbjVV 4r<r<     44444! LLLLL'''dffffff$!{$Q ''  LL. L LddTL]%lP0! t,%$%8% x';I US'''$'''! %''''''''' : FARNHAM RUGBY UNION FOOTBALL CLUB  MEMBERSHIP FORM 2011/2012 CHEQUES MADE PAYABLE TO FARNHAM RUFC Playing Membership - used for . a) Senior Playing Member - anyone playing senior rugby for the club. (Note Senior players match fees 7/match) b) 1st child Mini / Junior / Academy (both incl one adult social membership (50), legally a child under 18 cannot be a Club Member). 95.00k Family Membership  used for .... a) Family of Senior Playing Member (95) plus one child at Mini / Junior / Academy (45). b) Family with 2 children in Mini / Junior / Academy (45 x2) plus Adult Social Membership (50). 140.00k  Additional Playing Child Fee (per child additional to the above categories)45.00Military Personnel & their families / Student / Unemployed - used for .... Subscription levels are set at the Clubs discretion. Individuals with specific circumstances should discuss them with their Senior Team Skipper or Mini/Junior Team Head Coach as applicable. 50.00k Social Used for members who have no playing connections50.00k FOUNDATION FUND DISCOUNTClaimTickWaiverTickSenior Player/Parents Registration Details (Please complete all bold sections) Senior Player / FatherMotherDivorced PartnerFirst Name(s)Last NameAddress (If Different)(If Different)Post CodeHome PhoneMobile PhoneEmail addressSenior player (or parent wishing to register as a player) please complete the following italic section: RFU Membership # Team (Vets/Other) Date of Birth PositionMini/Junior Players Details (please complete one line for each child) First NameSurnameAge GroupDate of birthRFU Membership NoSchool (Name)Medical Conditions (add separate sheet if required) Form Return at Registration : Senior players Please return to your coach/captain. Mini/Juniors : Please return one form for each family to the year group admin of your oldest child. Plus Parents MUST inform the year group admin of younger siblings, which age group you have registered with.  PHOTOGRAPHS: Please note that, in accordance with the League Rules, Photographs may be taken during matches. Such photographs may be published on the web site, might also appear in the local press & in club newsletters, but will not include the childrens names. CLUB COMMUNICATIONS: Tick the box on the right if you are happy to receive Cub documents by emailTickGift Aid Declaration: Please tick the box on the right if you wish all donations given by you since 6th April 2000 & any donations in the future to be Gift Aid. Please note - you must pay an amount of income and/or capital gains tax at least equal to the tax that the Charity reclaims on your donations in the appropriate tax year.Tick P.T.O . FARNHAM RUGBY UNION FOOTBALL CLUB  MEDICAL FORM 2011/2012 PLEASE COMPLETE ONE FORM PER PLAYING MEMBER PLAYERS NAMEFirst Name(s)Last NameAddress Post CodeHome PhoneMobile PhoneEmail address MEDICAL INFORMATION Please ensure that all necessary medication is with you or your child when they are playing and training. Asthma inhalers must be given to the coach, clearly marked with you or your child's nameIs the player named allergic to anything?Medical conditions, allergies (asthma, epilepsy, food allergies etc). Please give full details and use a separate sheet if necessary. Whilst not obligatory in the interest of your childs safety we recommend that you do complete this section fully. In the event of an injury or illness all reasonable steps will be taken to contact the above, and to deal with the injury or illness appropriately. In signing this section you give permission for your child to be given mild pain relief (paracetamol) if necessary, to be administered by the adult responsible for the age group. Signed:List medical conditions / allergies here: Youth rugby is normally safe and injuries are rare. Nevertheless, prevention is better than cure and, for our part, many of our coaches have Rugby Football Union qualifications and have also attended first aid courses. A medical problem or disability does not necessarily preclude a child from playing rugby, but your child's coach should be aware of anything to look out for and, if symptoms become apparent, what to do. Also, in the unlikely event of an injury when you are not present, we should be able to authorise emergency treatment.As a precautionary measure, Please let us know if your child suffers a serious injury, particularly concussion or a head injury, at home or at school.Tetanus: We strongly recommend that all players are up-to-date with anti-tetanus injections.I declare that the above information is correct. In signing this form I agree that the above named player can be bound by the laws and resolution of the Rugby Football Union (RFU) and its constituent Bodies and the rules and Codes of Conduct of Farnham Rugby Football Club.  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