York RLFC Wheelchair Rugby League Registration Form 
To register you or your child for this session please complete the booking form below:

The next two York RLFC Wheelchair sessions will take place at the Vale of York Academy (YO30 6ZS) on Monday 20th November and Monday 27th November (7.30pm - 9pm). Attendance to the session costs £5 per person and anyone wishing to attend, is asked to contact inclusion@yorkrlfc.com in advance and fill in the following Google form below.

Dawn Shore
inclusion@yorkrlfc.com
York RLFC Office on 01904 670880.
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I agree to abide by the Rugby Football League Code of Conduct.

 *
Participant First Name *
Participant Surname  *
Contact Email address *
Participant phone number or in the case of an participant under 18 years old Carer / Parent their phone number. *
Date of Birth *
Please give details of any medical conditions we should be made aware of. *
Photo Consent *
必填
Parent/ Guardian Name (if required)
Parent/ Guardian Email (if required)
Emergency Contact Name & Number *
I give permission for York RLFC to use my email to update me on news and events *
I give permission for York RLFC to share my email with club partners *
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