Youth Membership – Plan A (Monthly)

£7.00 / month for 12 months

Junior / Mini Membership Secretary : Steve Blanthorn

email : steveblanthorn@bhrfc.co.uk

Tel: 07894 082038

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.

One form per player

Players Full Name *

D.O.B: *

Childs RFU ID Number

Applying Parent / Guardian: *

Parents / Guardians D.O.B *

Parents / Guardians RFU ID Number

Parents / Guardians Email: *

Media Consent: *

Please select below if you DO or DO NOT want your child to be included or be used in any of the following:

Photo:

Video *

Internet: *

SKU: youth-mship-1 Category:

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