Minis & Girls Membership Form

Location

South Kerry Sports Centre,
‘Over the water’
Cahersiveen
Co.Kerry

Parent/Guardian Name *

Email Address *

Phone *

Street Address

City

State/Province

ZIP / Postal Code

Player Name *

Player Date of Birth *

Day *

Month *

Year *

Term & Conditions of Membership

As a member I/We agree to the following:

To inform the club (team coach/manager) of any relevant medical condition.
To inform the club (team coach/manager) of any injury sustained while playing Rugby within 2 weeks of its occurrence.
Accept responsibility for personal possessions.

Insurance cover:

The IRFU / Munster Branch provide a minimum level of insurance cover to all Youths, provided he/she is registered with the Munster Branch. The Union recommend that individuals should arrange additional voluntary top-up cover to supplement this. It is the individual Parents/Guardians responsibility to ensure that their child has adequate insurance cover.

By ticking this box I/we accept that we have read and understand the items above. *

I agree

Does the player have an existing medical condition that we need to be aware of?

YesNo

What medical condition does your child have that we need be aware of?

Does your Child need to bring medication with him/her?

YesNo

If yes, State the medication:

Do you consent to allow us to seek any medical treatment necessary in the event of any accident if you cannot be contacted?

YesNo

Emergency Contact Name

Emergency Contact Number

G.P.’s Name:

G.P.’s Number:

CLUB REGISTRATION DATA PROTECTION CLAUSE

I understand that it is necessary for Iveragh Eagles RFC (“the Club”) to collect and record the personal data on this form (“Personal Data”) for the contractual purpose of registering and maintaining my membership with the Club. I understand that the Personal Data may be shared with Provincial Branches and the IRFU from time to time and that the Club, the Branch and the IRFU are all Data Controllers.

I understand that the Personal Data will be retained by Iveragh Eagles RFC for the duration of the membership and in line with the Club Retention Policy. I further understand that I have a number of rights around the processing of Personal Data, including the right to request in writing a copy of my Personal Data which the Club holds, amend any information which is incorrect and to apply to have my Personal Data erased. I can also confirm that I have been given the opportunity to consult further relevant information concerning my data protection rights at www.dataprotection.ie.

I am aware of all my Data Protection rights and have given my consent, by ticking the boxes and signing below, for my information to be used as follows:

I consent for the Club to contact me with updates regarding the Club and including but not limited to activities such as match details, fundraising, ticket sales, meetings and events. *

Yes

I am aware that my photograph or video image may be taken whilst attending or participating in games or activities connected with the Club and I consent to it being used by the Club for match programmes, year books, match reports, event reports or on the Club website or social media channels. *

Yes

I understand that I can withdraw my consent at any time by writing to the Club.

Mini Membership (applies to all grade U12) €20. Please click the button below to complete your payment.

Credit/Debit Card Details *

Please enter your long card number, expiry Date and security code then click the button below to complete payment.