Chichester RFC Supporter Registration Form

Supporter Details
Title*	Dr Master Miss Mr Mrs Ms Unknown
First Name*
Surname*
Date of Birth*	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 January February March April May June July August September October November December format: yyyy eg. 1989
Gender*	Male Female

Main Address
Address 1*
Address 2
Address 3*
Post Code*
Home Number*
Mobile Number*
Work Number
Email Address*
receive Info from Sponsors	Yes

Alternative Contact in the event of Emergencies

First Name
Surname
Address 1
Address 2
Address 3
Post Code
Home Number
Mobile Number
Work Number
Email Address

Gift Aid

I am a UK taxpayer - Please reclaim Gift Aid on my donation

Terms and Conditons

Tick to Accept Terms and Conditions   View Details ?

I wish for my child to be allowed to take part in the rugby at Chichester RFC. I agree and understand that while the club coaches and helpers will take all reasonable care, they cannot be held responsible for any loss, damage or injury suffered by a child taking part in any of these activities unless such loss, damage or injury is directly attributable to the negligence of the said coaches and/or helpers in charge of the party. I acknowledge and accept that the club is not a commercial venture and that as such my child’s welfare when not actually playing rugby is my own responsibility and that, save where I consider that my child is old enough to take responsibility for his/ her own actions, I or another responsible adult will remain within the vicinity of the club. I wish to take part in the rugby at Chichester RFC. I agree and understand that while the club coaches and helpers will take all reasonable care, they cannot be held responsible for any loss, damage or injury suffered to myself in taking part in any of these activities unless such loss, damage or injury is directly attributable to the negligence of the said coaches and/or helpers in charge of the party. I acknowledge and accept that the club is not a commercial venture and that as such my welfare when not actually playing rugby is my own responsibility.