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!

Saturday 23rd September Action for Children DaySunday 24th September SchoolsFriday 29th September ECDC CorporateSaturday 30th September CommunityFriday 6th October ECDC CorporateSaturday 7th October UniversitiesSunday 8th October Blue LightsSaturday 14th October VerteransSunday 15th October Rugby ClubsSaturday 21st October CommunitySunday 22nd October CommunityFriday 27th October CommunitySaturday 28th October Finals
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.

PlayaXUKOur Affiliated CharitiesOur Affiliated SponsorsPlease do not contact me
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EARLS COURT BEACH RUGBY EVENTS - TEAMS REGISTRATION