WRU SCARLETS RUGBY CAMPS

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Booking Form
*Please note that this is a Inclusive Rugby Camp*

Email *

Attendee First Name *

Attendee Surname *

Please state your child's disability *

Is your child a wheelchair user and if so, can they self-propel or do they require assistance?

Self - Propel

Require Assistance

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Does your child have any special requirements that the coaching staff should be aware of?

Attendee Age *

Any Medical Conditions *

Yes

If yes, list condition and medication

Emergency Contact *

Image and Video Consent

Photographer & Videographer:
Photographs and videos of the participants will be taken at the camps. These photos will be used for official WRU & Scarlets marketing use and on the official website and social media channels. Please confirm below whether you give consent for the participant to be photographed and videoed;

Image and Video Consent *

Yes

Required

Local Rugby Club (If applicable)

Which camp(s) will you be attending? *

Inclusion Camp - Maes y Gwendraeth 16/8/21 [Max 70 Participants]

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