HONG KONG RUGBY FOOTBALL UNION

2002-2003 Season

PLAYER REGISTRATION FORM

s

 I)

PLAYER TO COMPLETE THIS SECTION AND RETURN THE COMPLETED FORM TO HIS / HER CLUB:

 

 

PERSONAL DETAILS:

 

HK Club Affiliation

 

 

Title:

Mr / Miss / Ms / others: please specify:

 

First Name

 

 

Surname

 

 

Other Names

 

 

Phone

 

(H)

 

 

(O)

 

 

(M)

 

Fax

 

(H)

 

 

(O)

 

Email

 

 

Address

 

 

Preferred Contact Method:  By email / fax / phone / post / others: please specify:

 

Gender:

M / F

 

Age

 

 

Date of Birth (dd/mm/yyyy)

 

 

Place of Birth

 

 

HK ID#

 

 

Passport #

 

 

Date of Issue (dd/mm/yyyy)

 

 

Place of Issue

 

 

Expiry Date (dd/mm/yyyy)

 

 

Nationality

 

 

Date of First Arrival in HK (dd/mm/yyyy)

 

 

Current Period in HK (dd/mm/yyyy)

 

 

Have you been in residence in HK for a consecutive 3-year period?

Y / N

 

CURRENT PLAYING EXPERIENCE / POSITION:

 

Date Joined Club (dd/mm/yyyy)

 

 

Position Playing

 

 

Preferred Position

 

 

Grade / Division

 

 

Club Position:

Chairman / Team Captain / Co-ordinator / Coach / Referee / Player / Others: please specify:

 

LAST 5 YEARS CLUB HISTORY

 

Club (Country)

 

Period at Club

 

Position Played

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NOTE: Players will be eligible for the physio benefits arranged by the Union one month after HKRFU accepts this Registration Form.

 

PLAYERS DECLARATION:

 

I acknowledge that the HKRFU has a Death & Permanent Total or Partial Disability Insurance Scheme in operation for all registered players, but this does not cover for my medical or hospital care.

 

I confirm that I have obtained the necessary clearance from my previous Union and Club and / or I have no reason to believe that my previous Union and Club would object to my playing rugby in Hong Kong.

 

ALL PLAYERS ARE RECOMMENDED TO OBTAIN THEIR OWN MEDICAL INSURANCE TO COVER INJURY OR HOSPITALIZATION.

 

Signed

 

 

Date

 

 

II)

CLUB TO COMPLETE THIS SECTION AND RETURN TO HKRFU OFFICE (FAX: 2576 7237)

 

CLUB AUTHORIZATION:

 

We,                                                                    (Name of Club) confirm that                                               (Name of Player) is currently a playing member of our club.

 

Authorized by:

 

 

 

 

 

 

 

Signature of Club Secretary / Chairman

 

Name of Club Secretary / Chairman

 

 Date

ALL INFORMATION GIVEN ON THIS REGISTRATION FORM WILL BE TREATED AS CONFIDENTIAL BY THE HKRFU.