Senior Membership

The club membership form for the Senior Club is below.  We are working on providing a downloadable version but in the meantime you can copy the form below into a Word document and print and forward to our membership secretary Rhys Hughes or contact Rhys and ask for a form.

Rhys Hughes, 85 Mwrog St, Ruthin, LL15 1LB.  e-mail Rhys@p-a-group.com

 

Clwb Rygbi Rhuthun - Ffurflen Aelodaeth

Ruthin Rugby Club - Membership Form

 

I would like to join Ruthin Rugby Football Club, Cae Ddol, Ruthin.  I understand that Ruthin Rugby Football Club, its servants, agents or employees are not under any liability, whatsoever for loss of property, accidents or injuries however caused during the course of spectating, training, preparation or matches played at Ruthin Rugby football Club or any other ground.

 

Section A (to be completed in BLOCK CAPITALS)

 

Name:                                     _______________________________________

 

D.O.B.                                      _______________________________________

 

Address                                   __________________________________________________________

 

Home Tel                                ____________________________

 

Mobile Tel                               ____________________________

 

E-Mail                                     ____________________________

 

Occupation                              ____________________________

 

Playing Position                      __________________________________________

 

Previous Club                          __________________________________________

 

 

Section B (Medical History – Players Only)

 

Do you suffer from any medical conditions  Yes / No

 

If Yes, please advise               ___________________________________________________________

 

 

Section C (Membership Type)

I wish to apply for the following membership

 

                                                               

Full Playing             £50               Youth / Student                      £30

Full Playing (S/O)   £45                Junior                                      £40                         

Full Non-playing     £40                 Patron                                   £100                                                                     

 

Family Membership:              1 playing child £50   /   2 playing children £75   /   3 playing children £90

                               

I wish to pay by Cash /Cheque /Standing Order (Please complete Section D)

 

 

Section D (Standing Order Form)

I wish to pay annual membership subscription by standing order.

 

To: _____________________________                (Name of Bank) ______________________   (Branch)

 

I hereby authorise you to pay from my account  _________________________  (Name of account)

 

Sort Code  _________________  Account No____________________

 

The sum of  £_____on the 1st ____________ 2013  and thereafter every year to Ruthin Rugby Club at Barclays Bank, North Wales Central ( Sort Code 20-25-76, Account No 90788783).

 

Signed     __________________________________                            Date        ___________________

 

Completed forms with payment to be handed to your team manager or send to Rhys Hughes, 85 Mwrog Street, Ruthin. LL15 1LB.

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