Club Membership Secretary :
Tracy Davies
72 Merrow Woods
Guildford
Surrey
GU1 2LN
Tel : 01483 511511
Email : membership@grfc.co.uk
Application for Membership Season 2015/16
Please complete the form in capitals.
One form required per member.
Two passport sized photos are required for all players in the youth age groups (U13 – U18’s) if not provided in the last 2 years.
Member Details
Full Name
Gender
Male / Female
Date of Birth
Address
Any medical conditions
Previous Club (new players)
If Introduced by a club member – please enter name
How did you hear about us
Age (this academic year)
School (juniors only)
Additional information – Juniors Micros – U18’s Members Only
1st
2nd
Relationship to member 1st
2nd
Address(if diff. or additional
2nd
Parent / Guardian
to above)
Occupation
1st
2nd
Home phone number
1st
2nd
Mobile (Emergency) No 1st
2nd
1st
2nd
Email Address *
Additional information – Senior , Social & Touch Members Only
Nationality
Occupation
Home phone number
Mobile No
1st
Email Address *
1st
2nd
Emergency Contact &
Contact
relationship to player
No.
* Please print carefully, we use email to communicate with our members to keep costs low – please enter at least one email address
Volunteers Please note that Guildfordians RFC is entirely run by unpaid volunteers.
Throughout the season all parents and senior members will be asked to help with various tasks such as the duty rota, festivals etc.
Please give your support wherever possible – the club can’t run without your help and many hands make light work.
If you would like to volunteer specifically in certain areas - help is always needed in the following
Please circle : Catering Administration Coaching First Aid / Physio Buildings Maintenance Club Shop Festival
Other ……………………............
Please turn over to complete your application
Membership Fees 2015/ 2016
Seniors : Single Payment (No match fees)
Seniors : Pay as you Play
Seniors : Standing Order (No match fees)
Seniors : Students, Armed forces & Unemployed. Proof required.
Juniors : Micros & U6’s
Juniors : U7’s - 16’s
Juniors : Siblings U7’s – U16
Juniors : U17’s & U18’s and Girls aged 12+
Social : Non Playing Social Member - 1 year
Social : Non Playing Social Members - Life Time
Touch : General
Touch : Club ( for paid up club members)
Fee
£180
£10 full game £5 half a game
£25 per Month for 8 Months
50% discount on the above
£50
£90
£60
£30
£20
£120
£45
£25
Please tick
Players are only covered by RFU insurance once a completed membership form is received by the club.
The Junior membership fee includes the players’ listed parents/guardians as playing members of the club.( Additional Fee / Match Fee
will be required to play senior rugby)
New Junior Members can play as a Temporary Member for three sessions before any membership fees become due.
If the above named person wishes to become a Full member thereafter, the appropriate membership fee must be paid.
Payment Details
Cheques
Bank Transfers
Juniors, Social , Touch
Made Payable to ‘GMRFC’
Sort Code 400530 Account 51858521
Seniors
Made Payable to ‘Stoke Park RFC’
Sort Code 402226 Account 72292556
Please write the members Name & Age Group \ Section on the reverse of cheques.
By signing this completed form, I understand and agree to the following :
 (Parents Micros – u18’s) - My son/daughter taking part in the activities of the club and I am responsible for them immediately
before and after every club session (including training sessions, matches, social etc.).
It is absolutely essential that at the end of the session someone is there to collect the players on time.

(Parents Micros - u12s) - To remain on site at Guildfordians RFC at all times. Guildfordians RFC does NOT operate a 'drop & leave'
facility. We like parents/guardians/accompanying adult to stay, watch and encourage the children during the sessions. If a child
has to be left for any reason a responsible adult must be left in charge of the child and both the child and the child's coach must
be advised as to who that responsible adult is and I confirm the details shown on this form are correct.

I consent to the club maintaining records and information relating to the above named player confidential electronic documents
and in club information folders for the purpose of club administration. I understand that I have a right to see this information if I
so desire, providing I give appropriate notice. It is my responsibility to keep the club updated with all relevant information,
especially emergency contacts and medical details.

I agree to abide by the Club’s & RFU Codes of Conduct and Club's Disciplinary Code as may be amended from time to time.

Guildfordians RFC, its servants, agents or employees (all volunteers), are not under any liability whatsoever for loss of property,
accidents or injuries, of or to the above named player however caused during the course of training, matches or other events.
In the event of any injury or illness, all reasonable steps will be taken to contact me, and I give permission for the club and/or any
medical authorities present, to administer any appropriate or necessary medical attention.
The club may wish to take photos or videos of the team or players solely for promotion and celebration of club and RFU activities and
training purposes. Please indicate if this is acceptable to you: ◻ YES ◻ NO. Please share any additional information with the club
Safeguarding Officer.
Complete Your Application
Signature of Senior Player, Touch Player, Social Member or Parent / Guardian of a Junior player.
……………………………………………………………..………..………………
Date …....../..…..../…..…
For Guildfordians RFC Use Only
Membership Number
RFU Number
Membership Fee
Received on
Payment Method (Cheque / Cash / Other)
Membership
Notes
(New \ Renewal)