Please submit your preferred club and you should receive an email confirmation shortly

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Parent(s) Name*

Email:*

Parent Phone Number(s)*

Child Name*

Child's Birth Date*

Location & Date*

Putney - Sat
Fulham - Sat

Term*

Autumn Term (15 weeks): 10 Sept - 17 Dec £165
Spring Term (13 weeks): 7 Jan - 1 Apr £143
Summer Term (13 weeks): 22 Apr - 15 Jul £143

Club*

Micro (2 - 3.5)
Mini (3.5 - 5)

Rugby Shirt size

2-3 year old
3-4 year old
4-5 year old
5-6 year old

I consent to photos of my child being taken whilst playing for the company's website*

Yes
No

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