Socitey Membership Form

RGU: UNION Societies 2007/08 MEMBERSHIP FORM

You will need to fill in a form for each society you have joined.
Name:  
Matric:  
Date of birth: dd/mm/yyyy  
     
Society/Sport Club:  


YOUR CONTACT DETAILS
Address:  
Mobile Phone Number:  
Landline Phone Number:  
Contact E-Mail:  


EMERGENCY CONTACT DETAILS
Name:  
Relationship (Parent/Aunt/etc.):  
Address:  
Mobile Phone Number:  
Landline Phone Number:  


MEDICAL INFORMATION
Please inform us of any relevant medical conditions or medication being taken

RGU: UNION will hold this information in strict confidentiality. It will only be accessed in emergencies, and destroyed at the end of the session.



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