Rugby Camp booking - Starting XV

Parent / Guardian details

Parent / Guardian Name*

First Last

Parent / Guardian address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent / Guardian Phone*

Parent / Guardian Phone 2*

Parent / Guardian Email*

Which camp are you booking for?*

How many places would you like at the camp?*

Attendee 1 details

Please fill out the details for the first child attending the camp for this booking

Attendee 1 Name*

First Last

Attendee 1 Date of Birth*

Attendee 1 T-Shirt size*

Are there any medical conditions for attendee 1?*

Yes
No

Please tell us about attendee 1's medical conditions:*

Media Consent Attendee 1

We may use photography and filming of our rugby camps for promotional purposes. If you do not wish to be included in this photography, please tick the box.

Please don't include me in photography or filming

Attendee 2 details

Please fill out the details for the first child attending the camp for this booking

Attendee 2 Name*

First Last

Attendee 2 Date of Birth*

Attendee 2 T-Shirt size*

Are there any medical conditions for attendee 2?*

Yes
No

Please tell us about attendee 2's medical conditions:*

Media Consent Attendee 2

We may use photography and filming of our rugby camps for promotional purposes. If you do not wish to be included in this photography, please tick the box.

Please don't include me in photography or filming

Attendee 3 details

Please fill out the details for the first child attending the camp for this booking

Attendee 3 Name*

First Last

Attendee 3 Date of Birth*

Attendee 3 T-Shirt size*

Are there any medical conditions for attendee 3?*

Yes
No

Please tell us about attendee 3's medical conditions:*

Media Consent Attendee 3

We may use photography and filming of our rugby camps for promotional purposes. If you do not wish to be included in this photography, please tick the box.

Please don't include me in photography or filming

Attendee 4 details

Please fill out the details for the first child attending the camp for this booking

Attendee 4 Name*

First Last

Attendee 4 Date of Birth*

Attendee 4 T-Shirt size*

Are there any medical conditions for attendee 4?*

Yes
No

Please tell us about attendee 4's medical conditions:*

Media Consent Attendee 4

We may use photography and filming of our rugby camps for promotional purposes. If you do not wish to be included in this photography, please tick the box.

Please don't include me in photography or filming

Payment

Terms & Conditions*

By ticking this checkbox and submitting the form you are agreeing to our Terms and Conditions

I agree to the Terms and Conditions

Total

£ 0.00