Junior Membership nomination
As a member of the Junior Rugby Sub-Committee of the Eastern Suburbs Rugby Union Football Club Inc. I hereby nominate the following person for Junior membership of the Association in accordance with Rule 11.C (i) of the Constitution.
Name
*
First Name
Last Name
Date of birth
*
/
Day
/
Month
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (00) 0000-0000.
Nominator (must be a member of the Junior Rugby Sub-Committee
*
First Name
Last Name
Nominator's signature
*
Date
*
/
Day
/
Month
Year
Date
As parent/guardian of the nominee named above, I approve of them participating in the Junior Playing Group of the Club and having photographs taken in association with that participation. I confirm that they will abide by the Constitution and Policies of the Association.
*
First Name
Last Name
Parent/guardian signature
*
Click here to read the Constitution and policies.
Continue
Continue
Should be Empty: