BLUES RUGBY

Summer 7’s

FUN & FAST

7 ON 7 RUGBY!

May thru July 2008

Practices every Tuesday and Thursday

Starting Tuesday May 6 th 2008

From 6:00 to 8:00

@ Cedar Beach Fields in Allentown. Field on Ott Street across from Cedar Beach Pool.

Note: During the 7’s season and because of the practice times (Parents should be home from work and able to drive), players must arrange transportation to and from practice. To lessen the duty, car pools from the different areas should be worked out accordingly.

Only $25 to register –Players & Parents must fill out forms below and bring to first practice. Bring spikes, shorts a mouth guard and cold water!

Write checks payable to Allentown Blues Rugby Football Club.

 

 

Check the WEB: www.gotthardt.net/blues

Spring , Fall and Summer Rugby participation benefits Youth and High School students in all school districts throughout the Lehigh Valley!

Coach Dan Benedict (Over 25 years combined playing and coaching experience)

610-432-8281

The 2008 Blues Summer 7s Rugby Participation Form

I give my son ______________________________,

Permission to participate in The 2008 Blues Summer 7’s Rugby Season.

Club Name __Allentown Blues RFC.________________________

Date of Birth (mm/dd/yyyy): ____ / ____ / ______

First Name: _________________________________

Last Name: _________________________________

Mailing Address:__________________________________________

City: _______________________________________ State: ____ Zip: _____________

Phone: (___) _____________________________

E-mail address: _______________@___________________________

Authorization for Emergency Treatment of Minor

  1. The undersigned is the parent/legal guardian of the minor identified.
  2. This authorization is being provided to the Emergency Services Department for use in the event of the need for emergency treatment of the minor identified, when neither the undersigned emergency contacts can be reached to provide consent to or for treatment.

In case of emergency please contact:

Name_______________________________

Address_____________________________

Phone______________ Cell _________________

2nd contact:

Name_______________________________

Address_____________________________

Phone______________ Cell _________________

 

Signature: ______________________________________Date: __________________________

Parent/Guardian Signature: ______________________Date: __________________________

(if under 18 years old)

Please attach and send with a copy of Insurance card.