Membership Form

"*" indicates required fields

Name*

First Name Last Name

Member's Name (parent/guardian details for players 16 or under)

Date of Birth*

Is this:*

A new membership

A renewal

Membership Number*

If a renewal please enter your membership number in the field above:

Address (including postcode)*

Telephone Number*

Email*

What type of membership do you want*

Family membership includes rugby playing membership for one parent and one child, except that Mini Family membership includes 2 children. Click here for membership types.

Partner's name (family membership only)

First Name Last Name

Family Membership includes one adult playing member and an adult social membership

First Playing Child (U5-18)*

First Name Last Name

Date of Birth*

Sex*

School Year*

Medical Conditions / Disabilities

Number of additional children (if any)

£25 per additional child. Please remember that Family Membership includes one child and Mini Family Membership 2 children.

Second Playing Child (U5-18)*

First Name Last Name

Date of Birth*

Sex*

School Year*

Medical Conditions / Disabilities

Third Playing Child (U5-18)*

First Name Last Name

Date of Birth*

Sex*

School Year*

Medical Conditions / Disabilities

Fourth Playing Child (U5-18)*

First Name Last Name

Date of Birth*

Sex*

School Year*

Medical Conditions / Disabilities

I would like to pay by*

Online Bank Transfer

GoCardless – fee split into equal monthly payment (last payment no later than Apr 24)

Cheque

Credit / Debit Card

Pay online: Worthing Rugby Football Club, Barclays Bank plc, Sort Code 20-98-74, Account Number 60313483; The Club Office will contact you if you wish to set up a GoCardless payment scheme; Please either telephone the Club or call into the office/bar to pay by credit/debit card.

Get regular updates on what's happening at your club

I agree to receive regular Club updates by email

E-mails are the main form of Club communication and all Club Notices eg for AGMs etc will be sent only by email unless specifically requested by post.

The 500 Club offers an exciting chance to support and improve our facilities for “rugby for all” and to win cash prizes four times a year in March, June, September and December

I would like to hear more about the 500 Club

I agree to the terms and conditions of membership*

I agree

Read our Terms and conditions

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Dynamic community.

Shared enthusiasm.

Worthing RFC Membership