Earls Court Beach Rugby Registration Form

EARLS COURT BEACH RUGBY EVENTS - TEAMS REGISTRATION
Player Name

First NameLast Name
Player Birth Date

MonthDayYear
Parent Contact Name if under 18

First NameLast Name
Contact Phone

Area CodePhone Number
Contact E-mail
example@example.com
Please tick the date/dates you would like to register to play on the Beach!
Team Captain's Name

First NameLast Name
Team Name - If you do not have a team and would like to join another team please type - Join a Team
(If you are playing in Multiple teams, please write down all)
Team Colours
Emergency Contact Number

Area CodePhone Number
Are you happy to be contacted to hear more about PlayaX Beach Rugby events and any affiliated businesses or charities? Please tick all that apply.
Should be Empty:

EARLS COURT BEACH RUGBY EVENTS - TEAMS REGISTRATION