Application Form                                                             Season 2007/2008

RETURN THIS FORM  TO:

D. HART, 7 HAWKWOOD RISE, BOOKHAM, SURREY, KT23 4JS

I would like to join Effingham & Leatherhead Rugby Football Club(“the Club”).  I understand that the Club, its servants, agents, employees or coaches are not under any liability whatsoever for the loss of property, accidents or injuries of, or to, myself, however caused, whilst on the Club premises, during the course of training, preparation or matches played at the Club or other grounds.

Full Name:                                                                                                                                                   

Address:                                                                                                                                                       

                                                                                                                PostCode:                                     

Telephone Number:                                                                                Mobile:                                           

E-mail:                                                                                                                                                          

Please tick         type of Membership required:

*              This includes the £2.50 payment of match fees per week

**           This includes the £5.00 payment of match fees per week

I enclose a completed Standing Order Form / Cheque payable to Effingham & Leatherhead RFC

SIGNATURE:                                                                                       DATE:                                                                   

Date of Birth:                                           ____________________________________________

(Student  Members only)

College:                                                                                                                                                        

(Student  Members only)

Preferred Playing Position(s):             _____________________________________________

PLEASE NOTE: FOR A STUDENT OR PLAYING MEMBER, UNTIL THIS RENEWAL FORM IS FULLY COMPLETED AND THE RELEVANT SUBSCRIPTION PAID, YOU ARE NOT CONSIDERED A CLUB MEMBER AND THE CLUB’S RFU ACCIDENT/LIABILITY INSURANCE COVER IS NOT AVAILABLE TO YOU.   MOREOVER, YOU ARE NOT ELIGIBLE TO PLAY IN ANY LEAGUE FIXTURES OR OTHER RFU ORGANISED COMPETITION MATCHES.

Effingham & Leatherhead RFC strongly believe in adopting and implementing best practice for child protection and welfare. We are a club that is committed to ensuring that equity is incorporated across all aspects of our club’s development. That should be evidenced by our adoption of codes of conduct for players, coaches, spectators and referees, as well as demonstrating equitable and best practice. We have a club welfare officer and assistants, all adults in supervisory contact with children must be CRB cleared; coaches, referees, assistants etc are encouraged to attend formal and informal equity and child protection courses.

Equity Statement

This club is committed to ensuring that equity is incorporated across all aspects of our development. In doing so we acknowledge and adopt the following Sport England definition of equity:

·          Sports equity is about fairness in rugby, equality of access, recognising inequalities and taking steps to address them. It is about changing the culture and structure of rugby to ensure it becomes equally accessible to everyone in society.

·          The club respects the rights, dignity and worth of every person and will treat everyone equally within the context of rugby, regardless of age, ability, disability, gender, race, ethnicity, religious belief, sexuality, nationality or social/economic status.

·          The club is committed to everyone having the right to enjoy their rugby in an environment free from threat and intimidation, harassment and abuse.

·          All club members have a responsibility to oppose discriminatory behaviour and promote equality of opportunity. The club will deal with any incidence of discrimination seriously, according to the club’s disciplinary procedures.

The club will take steps, as appropriate, to encourage membership from different groups and diverse communities.

Policies and codes of conduct

The club has adopted and adapted  RFU policies and codes of conduct:

These are explicitly part of your membership breach of which are dealt with by the disciplinary process.

Full details of all these policies and procedures are available on the club website(s) and in hard copy in the main register in the club house. Additionally they may be distributed in whole or in part via e-mail, regular mail or other communication.

I AGREE to abide by the above principles, practices and codes and to help achieve these aims in all aspects of our club.

_____________________________ __________________________________ __________________

Name                                                                     Signed                                                                   Dated