Join Join Clubba Football Club — Membership Website Membership type Select membership type -- Please select -- Social Membership Your details (Lead / Main Contact) Forename * Surname * Known as (optional) * Email address * Mobile number * Address * Town/City * Post code * Playing details (Lead) RFU number * Date of birth * Do you have any medical conditions? * Yes No Please give details Emergency contact name * Emergency contact number * Relationship to you * Optional second emergency contact name Optional second emergency contact number Relationship to you Club roles (you) Currently carrying out a club role? Yes No Which role(s)? Club Sponsor First Aider Junior Co-ordinator Mini Co-ordinator Mini/Junior Fixture Secretary Safeguarding Assistant Safeguarding Officer Team Coach Team Manager Team Sponsor Volunteer Interested in taking on a club role in future? Yes No Which role(s) would interest you? Club Sponsor First Aider Junior Co-ordinator Mini Co-ordinator Mini/Junior Fixture Secretary Safeguarding Assistant Safeguarding Officer Team Coach Team Manager Team Sponsor Volunteer Second guardian Add a second parent/guardian to this membership A second guardian is required for this membership type. Forename Surname Email address Mobile number RFU number Club roles (second guardian) Currently carrying out a club role? Yes No Which role(s)? Club Sponsor First Aider Junior Co-ordinator Mini Co-ordinator Mini/Junior Fixture Secretary Safeguarding Assistant Safeguarding Officer Team Coach Team Manager Team Sponsor Volunteer Interested in taking on a club role in future? Yes No Which role(s) would interest you? Club Sponsor First Aider Junior Co-ordinator Mini Co-ordinator Mini/Junior Fixture Secretary Safeguarding Assistant Safeguarding Officer Team Coach Team Manager Team Sponsor Volunteer Children + Add a child Child Forename Surname Known as (optional) Date of birth RFU number * Age band -- Please select -- U6 U7 U8 U9 U10 U11 U12 U13 U14 U15 U16 U17 Relationship to you School / college / employment * School College Employed Unemployed School/college/employer name Town Does this child have any medical conditions? * Yes No Please give details I consent to photographs of my child being used in internal club material * Yes No Emergency contact name Emergency contact number Relationship to child Optional second emergency contact name Optional second emergency contact number Relationship to child Remove this child Consents and declarations I have read the privacy notice and understand how the club will use the information on this form, including medical details, to run the membership safely. * I agree to the Code of Conduct * I have explained the Code of Conduct to my child(ren) * I agree to the RFU Concussion Protocol * I agree to RFU GMS System registration * I understand and agree to the club membership fees terms * I agree the club may contact me about social and club activities * Yes No * = required for this membership type Payment Monthly Half year (pay in one) Full year (pay in one) Discount/voucher code (optional) Check code Cost Monthly subtotal£0.00 Club maximum applied£0.00 / month Voucher discount−£0.00 Amount payable Monthly£0.00 Every 6 months£0.00 Per year£0.00 You will pay: £0.00 Continue to payment Powered by Clubba™ Club and Society Membership Software