Junior Rugby Membership

£0.00

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Mini Juniors Membership Form

Please complete all the following sections in order to register with the club for the 2025/26 season, this is required for ALL players including training only players.
Scunthorpe Mini/Juniors RUFC is committed to keeping your personal data safe and will not use the information you provide for any purpose other than for player registration purposes.
Player registration fees are as follows:
Boys Season subscription £110 per season
Girls Season subscription: £70
Mixed U6 : £70

Which team are you registering for?*

Player First Name*

Player Last Name*

Address*

Street Address Address Line 2 City Post Code

Contact Number*

Email Address for Club Correspondence*

Player Date of Birth*

Team to be registered with:*

Kit Size*

Please indicate how you intend to pay the subscription fees:*

Bank Transfer

Cash Handed to Team Manager

Cheque

Pay Online

Club preference is bank-transfer but cash and cheque also ok. If paying by online banking please put the PLAYERS NAME AND AGE GROUP as reference, account details are: Name: Scunthorpe Mini Rugby Section Acc No: 30048977, Sort code: 05-07-57. Cheques should be made payable to 'Scunthorpe Mini Rugby'

Please outline any special dietary requirements

Emergency Contact 1

Contact Name

Contact Phone Number

Relationship to child:

Parent

Carer

Person with parental responsibility

Other

Emergency Contact 2

Contact Name

Contact Phone Number

Relationship to child:

Parent

Carer

Person with parental responsibility

Other

Doctors Information & Medical Info

Name of Doctor / Practice (for medical purposes)

Telephone

Address

Street Address Address Line 2 City Post Code

Please outline any medical conditions that require medication:

Parent & Carer Information

IMPORTANT INFORMATION*

PLEASE READ & TICK TO CONFIRM YOU'VE UNDERSTOOD

Scunthorpe R.U.F.C. & it’s officials are not under any liability whatsoever for the loss of property, accidents or injuries howsoever caused during the course of training, preparation or matches played at Scunthorpe R.U.F.C. or other grounds. Registered playing members of Scunthorpe R.U.F.C. are covered by insurance against death or disablement as laid down in the Rugby Union Guidelines. Parents/Guardians are advised that any additional insurance is their responsibility. Injuries are rare but, I Agree to my child being treated by any qualified firstaider provided by Scunthorpe R.U.F.C. or opposing club should an injury occur & to my child being transported to a hospital should this be considered necessary. I understand that Scunthorpe R.U.F.C. will notify me as soon as practicable. We abide by England Rugby Headcase rules and if Concussion is suspected you must inform the childs school and G.P as a matter of urgency. Further Information can be found on the England Rugby website. All officials, Coaches, managers and First Aiders will hold a current and valid DBS. Parents/Guardians, Spectators & Players agree to abide by the RFU Codes of Conduct (These can be found on the notice board outside the Changing Rooms & on the RFU website www.rfu.com) and by the rules of Scunthorpe R.U.F.C. and Heslam Park Club (These can be found in the Green Book and Mini Junior booklet). Data protection: Parents/Guardians please note your privacy and the security of your personal information is always at the forefront of SRUFC. As a result, and as required by GDPR, we will make it easier for you to find out how we use your information. We collect and process personal data from you or your child when you join and when we carry out annual renewals of your membership, for the purpose of advertising club activities and promotions and we will share some of your data with the RFU. Please read the new Privacy Notice so you are fully aware of your rights and how we use your personal information. You can access the Privacy Notice detail via the RFU website www.englandrugby.com All players are registered with RFU

Code of Conduct

You can read the code of conduct here: http://nett.tl/10d3c5a

Total

Name

This field is for validation purposes and should be left unchanged.

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Category: MiniJuniorForm