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Hitchin Rugby Limited Membership Form

( Please note that this is not an RFU Registration Form )

Firstname:

Lastname:

Nickname:

Address:

Town:

County:

Post Code:

Home Tel:

Work Tel:

Mobile:

eMail:

Preferred Playing Position:

Alternate Playing Position:

Date of Birth:

Employer:

Profession:

Emergency Contact:

Relationship:

Notes / Comments / Medical Condition (asthmatic, etc):

Prior Clubs and Playing Experience

Security Code:

The Code: Enter the code above

Please note, by submitting this form you agree for these details and these only to be held on a computer database. They will not be passed to any other organisation

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Hitchin Rugby Limited, King George V Playing Fields, Old Hale Way, Hitchin, Hertfordshire SG5 1XL England, Charity No. 1159772
enquiries@hitchinrugby.com T: +44 (0)1462 432679