Whinmoor Warriors ARLFC

Whinmoor Warriors ARLFC

Season 2026 Consent Form
Player Details
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth*

DayMonthYear
Date
Team/Age Group

Health Needs
Does your child have any medical conditions that we need to be aware of? e.g. asthma, epilepsy, diabetes, allergies, autism, ADHD, recurring injuries*

YesNo
Please list all medical conditions (please put N/A if not relevant).*
Please provide details of any regular medication below (please put N/A if not relevant).*
Dietary Requirements
Does your child have any specific dietary requirements we need to be aware of? e.g. allergies, coeliac, lactose intolerance, gluten intolerance*

YesNo
Please provide details of any allergies below (please put N/A if not relevant).*

Emergency Parent/Carer Contact Details
In case of an emergency please contact the person below.
Full Name*

First NameLast Name
Phone Number*

Phone Number
E-mail*
example@example.com
In the event that the above person cannot be contacted, please provide an alternative emergency name and number.
Full Name*

First NameLast Name
Phone Number*

Phone Number

Parents/Carer’s Consent
I will ensure to inform the club as soon as possible of any changes to the information and/or medical circumstances outlined above. In the event that my child is injured whilst playing rugby, I hereby give consent for my child to receive medical attention.
I give permission for photos to be taken of my child and shared on the Whinmoor Warriors Club and Team’s public social media platforms and website.*

YesNo
I understand that there are associated subs to be paid to the club for the forthcoming season of £120, and commit to paying these by one of the following methods:
- Paid in full prior to the 1st March (a 15% discount will be applied for payment in full by this date).
- Paid monthly at £15/month over a period of eight months, via standing order, bank transfer or card payment within the first week of each month, starting 1st March.
Please select preferred payment method*

In FullMonthly
Declaration
I understand that failure to keep up with the monthly payments / constant and repeated non-payment will result in a mandatory meeting with the committee to discuss the situation and sanctions may be imposed.

I understand that the playing and training kit provided, remains the property of Whinmoor Warriors ARLFC and should be returned to the club/team should my child leave.

I understand that it is my responsibility to supervise my child at training and on match days.

If for any reason I am unable to attend/stay, I will make arrangements with another parent to supervise my child. This parent will be responsible for my child and their behaviour. I will inform the coach accordingly.

I commit to attending all post-match presentations, be they home or away as this is an integral part of the match day experience and promotes team bonding and gives the opportunity to support, encourage and applaud all participants.

I commit to conducting myself in an appropriate manner befitting of the club and that doesn’t bring Whinmoor Warriors into disrepute when:
1. attending events at external venues, either organised by the club (e.g. presentation nights) or hosted by others, where the club have been invited (e.g. Leeds Rhinos’ events/matches).
2. in public, wearing any club attire, including kit, presentation tops/hoodies, hats etc.
I acknowledge that this also extends to my child and any other individuals/ dependents that may be present.

I understand that, should any behaviour that casts Whinmoor Warriors in a negative light be witnessed and/or be brought to the committee’s attention, the committee shall review and assess the nature/severity of said behaviour and this will result in a mandatory meeting with the committee to discuss the action and sanctions may be imposed.

I have read, understand, and commit to following the club’s Code of Conduct for Parents/Carers/Spectators which can be found in the Information Booklet provided (copies are available in the club house and also on the website).

I have also explained the Code of Conduct for Players to my child to ensure they understand what is expected of them when representing Whinmoor Warriors.
By ticking below you acknowledge and agree to the above points.*

I agree
Name

First NameLast Name
Date*

DayMonthYear
Date
Should be Empty:

Whinmoor Warriors ARLFC

Player Details

Health Needs

Dietary Requirements

Emergency Parent/Carer Contact Details

Parents/Carer’s Consent

Declaration