Northumberland Rugby Union Representative Rugby Registration Form Season 2023/24 – County Under 17s Boys

"*" indicates required fields

Player Information

Address*
Include area code.
DD slash MM slash YYYY
Preferred Playing Position(s)*
Please note any allergies and include details of any past injuries including concussions.

Representative Rugby Permissions

Parent/Gardian Details*
First Name
Surname
Phone Number
 
Parent / Guardian Address (if different to players)

COVID – 19

I AGREE THAT ALL COVID 19 RELATED GUIDANCE ISSUED BY NORTHUMBERLAND RUGBY WILL BE FOLLOWED.

I AGREE THAT IF ANY MEMBER OF THE HOUSEHOLD IS UNWELL DUE TO COVID, WE WILL NOT ATTEND ANY TRAINING SESSIONS OR MATCHES WHILST HOUSEHOLD MEMBERS ARE UNWELL.

I AGREE THAT IF ANY MEMBER OF THE HOUSEHOLD SUFFERS SYMPTOMS OF COVID AND UNDERTAKES A TEST, IF THE TEST RESULT IS POSTIVE AND A TRAINING SESSION OR MATCH IS PLANNED OR HAS JUST TAKEN PLACE, WE WILL NOTIFY NORTHUMBERLAND RUGBY SO THAT TRACK AND TRACE MAY BE FOLLOWED UP IF APPLICABLE.
DD slash MM slash YYYY

Playing & Training Permission

I GIVE PERMISSION FOR INFORMATION REGARDING MY SON/GUARDIAN TO BE KEPT ON FILE AND ACKNOWLEDGE THAT INFORMATION WILL BE GIVEN TO TEAM MANAGERS, COUNTY PHYSIOS, COUNTY COACHES AND (IF APPLICABLE) NORTH SELECTORS AND FALCONS ACADEMY COACHES, ENSURING DUTY OF CARE IS FOLLOWED WHILST MY SON/GUARDIAN IS TRAINING OR PLAYING RUGBY FOR NORTHUMBERLAND RUGBY UNION.
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I GIVE PERMISSION FOR MY SON/GUARDIAN TO BE PHOTOGRAPHED AND/OR VIDEO’D WHILST PLAYING IN FESTIVALS OR COUNTY MATCHES OR TRAINING WITH OTHER COUNTY PLAYERS.
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I GIVE PERMISSION FOR MY SON/GUARDIAN TO RECEIVE MEDICAL TREATMENT FOR ANY INJURY RECEIVED WHILST TRAINING OR PLAYING FOR NORTHUMBERLAND RUGBY UNION.

PLEASE NOTE, A COPY OF THIS FORM IS GIVEN TO LEAD COACHES / TEAM MANAGERS IN A SEALED FILE SO THEY HAVE CONTACT INFORMATION AND THE RELEVENT PERMISSIONS FROM YOU IN THE EVENT OF AN EMERGENCY AT TRAINING OR AT MATCHES AND YOU ARE NOT PRESENT.
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I AGREE THAT IF ATTENDING ANY COUNTY TRAINING SESSIONS, MATCHES OR FESTIVALS, WE WILL BE RESPECTFUL AND FOLLOW THE CORE VALUES OF THE GAME – TEAMWORK, RESPECT, ENJOYMENT, DISCIPLINE AND SPORTSMANSHIP (TREDS).

VERBAL ABUSE OF REFEREES AND COACHES UNFORTNATELY IS ON THE RISE. IT WILL NOT BE ACCEPTED AND IF YOU ARE SEEN OR HEARD TO BE ABUSIVE TOWARDS REFEREES, COACHES AND VOLUNTEERS INVOLVED IN RUNNING COUNTY RUGBY, YOU WILL BE ASKED TO LEAVE THE GROUND.
DD slash MM slash YYYY
I GIVE PERMISSION FOR MY SON/GUARDIAN TO PLAY RUGBY FOR NORTHUMBERLAND RUGBY UNION
DD slash MM slash YYYY

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