First Block Payment Section 1 - Player DetailsPlayer's Full Name *Date of Birth *Select *GenderMaleFemaleCurrent Rugby Club (if applicable)Section 2 - Parent/Guardian DetailsParent/Guardian Full Name *Email Address *Phone *Section 3 - Rugby & DevelopmentWhat would your child most like to improve? *Rugby SkillsSpeed & athletic developmentConfidenceGame UnderstandingInjury prevention/StrengthMeeting new playersEnjoyment & extra rugbyHas your child previously been involved in: *School RugbyClub RugbyCounty/Rugby PathwayNone YetSection 4 - EventsAre you interested in attending our Launch Night? *Yes - Parent/Guardian AttendingMaybe - Send More InfoUnable To Attend But InterestedSection 5 - Permission & PaymentPermission & Consent *I confirm my child is fit to participateI give permission for my child to be photographed and/or filmed during this event, and for these images/videos to be used for promotional purposes (e.g. social media, website, marketing materials).I agree to Northern Outliers contacting me with information about sessions, events and programme updates. My information will not be shared with third parties.Waiver *Yes, I agree with the privacy policy and terms and conditions.Pay Now
