2022/23 Islay Rugby Club - Minis Membership Form

2022/23 Islay Rugby Club - Minis Membership Form

Please Note: you must first sign up your children for a SCRUMS account at scrums.scottishrugby.org before applying for Islay RFC membership as a SCRUMS ID is required.
Parent/Guardian Details
Parent/Guardian Name*

First Name Last Name
Parent/Guardian Mobile*
Parent/Guardian Email*
example@example.com
Address*

Street Address

Street Address Line 2

City County

Post Code
Child 1
Gender*

MaleFemalePrefer Not To Say
Name*

First Name Last Name
Date Of Birth*

Day 00Month 00 Year 0000
SCRUMS ID*
6 digits - You can find this on your 'My Profile' page on your SCRUMS online account. www.scrums.scottishrugby.org
Does this child have any medical conditions, allergies or medications? Please proved below.
Child 2
Gender

MaleFemalePrefer Not To Say
Name

First Name Last Name
Date Of Birth

Day 00Month 00 Year 0000
SCRUMS ID
6 digits - You can find this on your 'My Profile' page on your SCRUMS online account. www.scrums.scottishrugby.org
Does this child have any medical conditions, allergies or medications? Please proved below.
Child 3
Gender

MaleFemalePrefer Not To Say
Name

First Name Last Name
Date Of Birth

Day 00Month 00 Year 0000
SCRUMS ID
6 digits - You can find this on your 'My Profile' page on your SCRUMS online account. www.scrums.scottishrugby.org
Does this child have any medical conditions, allergies or medications? Please proved below.
Do you give Photo/Video Consent for your child/children?*

YesNo
I agree that Islay Rugby Club will contact the Parent/Guardian regarding membership fee payment. 1 child membership cost is £25, 2 or more children membership cost is £40*

I Agree
Should be Empty:

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