Easter Rugby Camp 2024 - Registration Form

Fatima College Grounds 26th- 28th March, 2024.

Name: ___________________________________________________________

Address: ___________________________________________________________
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Country: ___________________________________________________________
Phone No.: _______________________ Email:______________________________

Date of Birth: _______________ Age: ________________ Gender: _______/_______

DD / MM / YYYY M F

Playing position: ________________________________________________________

Any Allergies or Medical Conditions _______ / _______

NO YES

Details of Allergies / Medical Conditions:

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Jersey Size: ______ / ______ / ______ / ______ / ______

S M L XL XXL

E-mail: cstours2021@gmail.com
Name of Parent / Guardian: _______________________________________________

Phone No.: _______________________ Email: _______________________________

Emergency Contact: _____________________________________________________

I certify that the participant is in good health, proper physical condition and he/she can participate
in all normal rugby activities.
Custom Sports Tours and/or Sedbergh School will not be held liable for any loss and/or injury
suffered by any participant(s) during the camp.
I acknowledge that Custom Sports Tours and/or Sedbergh School reserve the right to use still
and/or video images of participant(s) for promotional and/or other purposes, and I consent to
said use.

__________________________ __________________________
Signature of Participant Date

__________________________ __________________________
Signature of Parent/Guardian Date

$350.00 Payment Received: _____________ Method: ______ / ______

DD / MM / YYYY Cash Cheque

E-mail: cstours2021@gmail.com