RFL Members Club Gold Application Form

Please complete all of the fields below to join the RFL Members Club.

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* 1. Name:

First Name

Last Name

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* 2. Email:

Email Address

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* 3. Occupation:

Roles Description

Company/Business Name

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* 4. Phone:

Day Time

Mobile

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* 5. Address:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

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* 6. Please select from the below membership options:

	*Annual Membership	One-time
RFL Members Club £1000 Gold	RFL Members Club £1000 Gold *Annual Membership	RFL Members Club £1000 Gold One-time

*Annual membership subscriptions include access to exclusive event tickets as well as the annual RFL Members Team dinner. Start date is when membership application form and payment is submitted by the applicant and/or received by RFL Members Club. Membership application is for RFL Members Club rugbyforlife.org.nz, set forth on the application form dated this date (the “Application”) are true, correct and complete. The Application is incorporated by reference and made a part of this Contract. RFL Members will pay the total fee of the option they have chosen eg yearly or as a one-time payment. RFL Members agree to a membership terms of which ever one they have chosen of either one-time or annual (1) year and acknowledge that the direct debits (payments) will continue for that period unless they terminate their membership with 1 month notice period.

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* 7. Payment Method:

Credit Card via Stripe - £1000

Bank Transfer - £0

You will pay at the end of this survey.

Bank Transfer Payment Details:
RUGBY FOR LIFE CHARITABLE TRUST
Bank account: ASB 12-3109-0163480-00
Charity registered number, incorporated as a Charitable Trust on 12th day of November 2020: 50053970 - NZBN: 942904879071