February Half Term Rugby Camps - Application Form

Players will participate in a wide range of activities aimed to increase the skill level required for the game in its various forms. No previous Rugby experience is required but participants will need studded boots and appropriate clothing. It would be advisable for players to also bring a light snack and plenty to drink.

Year 2 and 3 players will get a chance to develop their tag rugby skills. Year 4 players and above will be involved in Contact situations so a Gum Shield will be required. Girls in year 4 and above can opt to play contact or Tag rugby. If you require information on Gum Shields or have any other queries, please do not hesitate to contact your Rugby Development Officer, David McCormack, on 449766 or 07829 955123.

PLEASE NOTE THAT YOU WILL ONLY BE CONTACTED IF YOUR APPLICATION IS UNSUCCESSFUL.

HALF TERM RUGBY COACHING SESSIONSMy son or daughter is attending the following course(s):

Grainville: JRFC: Les Quennevais:

Please tick appropriate box(es)

Child’s name: School year:Child’s school:Home address:

Post code:Daytime telephone: Evening telephone:Parent/Guardian’s email:Emergency contact name and telephone:Please list recent vaccinations and health record (include any allergies, special needs, medical problems we should be aware of etc):

I consent to my son/daughter’s participation. I undertake to see that my son/daughter is provided with the required clothing/equipment where appropriate. To the best of my knowledge, my son/daughter is medically fit to participate in the activities involved and I undertake to inform you in advance of any alteration to this position.

Parent/Guardian’s Signature Date

On behalf of my daughter I would like to take advantage of the offer of a free place on the camp and my daughter would like to play Tag rugby contact rugby

I enclose a cheque for £15/£30/£45 (please circle) made payable to ‘Jersey Rugby Development Committee’. Please return together with this form to: David McCormack, Rugby Development Officer, Fort Regent, St Helier, Jersey, JE2 4UX.

ONLY TICK IF APPLICABLE: I DO NOT consent to photographs being taken of my child for use in promotional material or for media purposes.

Years 2, 3, 4, 5 & 6 Tuesday 14 February Grainville School 10am – 1pm Course Fee £15

Years 2, 3, 4, 5 & 6 Wednesday 15 February Jersey Rugby Football Club 10am – 1pm Course Fee £15

Years 2, 3, 4, 5 & 6 Thursday 16 February Les Quennevais Playing Fields 10am – 1pm Course Fee £15

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