Summer League - Team Registration

Team name* This is a mandatory field

Former team name (if required)

League*

Mixed

Mens

Ladies

This is a mandatory field

Team captain* This is a mandatory field

Team members*
(Two referees required per team)

Shirt #	Player name	Referee

Player name must not be empty You must select at least two referees

Street address 1* This is a mandatory field

Street address 2

Parish* This is a mandatory field

Postcode* This is a mandatory field

Home phone

Mobile

Email* This is a mandatory field

* Denotes a mandatory field.

Registration fees for Summer 2013 are £300 per team and can be paid by posting a cheque, made payable to 'Guernsey Touch Rugby LBG', or by BACS to the bank account detailed below.

All fees must be paid by Wednesday 5th June 2013. Cheques may to be sent to: Richard Duchemin, Apartment 1, Castleview, Les Canichers, St Peter Port, GY1 2LS

Bank: Lloyds TSB (Guernsey) Limited
Sort Code: 30-93-73
Account Name: Guernsey Touch Rugby LBG
Account Number: 02531667
Reference: SL - [Team Name]

I hereby declare that I am aware of and agree to abide by the FNB Touch Summer League Rules and Regulations. I further declare that payment will be made in a prompt and appropriate manner.

You must agree by ticking this checkbox.

Summer League - Team Registration

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