Member Registration

Chichester RFC Registration Form

Please Select registration type

Mini/Junior/Colts (U6-U18) Senior (18+ on 1st September)

Registration Fees

Mini / Junior / Colts

First child - £60

For each additional sibling - £40

Mini/Junior Coach - £10

Family Social Membership - £35

Colts U17-18 - £15

Senior Club

Senior Players including Match Fee - £180 or £15 / month by standing order(May - April) (Click here to download form)

Students including Match Fee - £96 or £8 / month by Standing Order (May - April) (Click here to download form)

Social Member - £35

Vice President - please enter your donation amount at the bottom of the page or register here and either send donation by cheque or use a standing order (Click here to download form)

Life Membership – please email the Membership Secretary (ben@bulpett.co.uk) for price

Please Select How many young players you would like to register with your Family

Medical Details
Doctors Name*
Doctors Address 1*
Doctors Address 2
Doctors Town*
Doctors PostCode

Tetanus Injection	Yes
Tetanus Booster	Yes
Consent for Medical Attention	Yes View Details ?

Medical Conditions, Allergies and Comments*

Playing History
Previous Rugby Club(s)
Playing History
Playing Position

Currently a Student

Yes No

Plays at School	Yes No
School Name
School Contact Number
School Post Code

Guardian 1

Relation
Title*
First Name*
Last Name*
Address 1*
Address 2
Town*
County*
Post Code*
Home Number*
Mobile Number*
Work Number
Email Address*	All registration issues will be sent to this email

Will you be playing?
Select Age Group you wish to coach:

Guardian 2

Relation
Title
Use same address as guardian 1
First Name
Last Name
Address 1
Address 2
Town
County
Post Code
Home Number
Mobile Number
Work Number
Email Address

Will you be playing?
Select Age Group you wish to coach:

Alternative Contact in the event of Emergencies

Title*
First Name
Last Name
Address 1
Address 2
Town
County
Post Code
Home Number
Mobile Number
Work Number
Email Address

How did you hear about the Rugby Club?

We are running a survey on behalf of the RFU and would like to know how you and your child heard about rugby, please select one of the following that is most applicable

Terms and Conditons

Tick to Accept Terms and Conditions View Details ?

Total Price: £

Title*
First Name*
Last Name*
Date of Birth*	format: yyyy eg. 1989
Town of Birth*
Country of Birth*
Gender*	Male Female

Title*
First Name
Last Name*
Date of Birth*	format: yyyy eg. 1989
Town of Birth*
Country of Birth*
Gender*	Male Female

Title*
First Name
Last Name*
Date of Birth*	format: yyyy eg. 1989
Town of Birth*
Country of Birth*
Gender*	Male Female

Title*
First Name
Last Name*
Date of Birth*	format: yyyy eg. 1989
Town of Birth*
Country of Birth*
Gender*	Male Female

Medical Details
Same as first young player
Doctors Name*
Doctors Address 1*
Doctors Address 2
Doctors Town*
Doctors PostCode
Tetanus Injection	Yes
Tetanus Booster	Yes
Consent for Medical Attention	Yes View Details ?

Playing History
Same as player 1
Previous Rugby Club(s)
Playing History
Playing Position

Main Address
Address 1*
Address 2
Town*
County*
Post Code*
Home Number*
Mobile Number*
Work Number
Email Address*