MEMBERSHIP FORM & RATES 2016-17 | Club | Buccaneers Rugby Football Club Athlone

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Buccaneers RFC membership form 2016/2017

All subscriptions due by 31st October 2016


Family Name______________________________________________________________________________________



  Player _______________     _____ _                                  DOB__________________   



 Player signature ____________________Contact No.______________________         School ____________





Home Contact No.______________________                   Contact email_______________________________________


Emergency Contact Number(s). ______________




Include all details that may be relevant in dealing with your child such as allergies, medication, special needs, behavioural issues etc.  (Further information maybe required depending on condition.)






Doctor’s Name          __________________                        Contact No. _____________________________ 



1).   Play for enjoyment and become part of the rugby family. 

2).   Respect the ‘Game of Rugby’ and play within the Laws of the Game.

3).   Accept the referee’s decision and let your captain or coach ask any relevant questions. 

4).   Play with control. Do not lose your temper.

5).   Always do your best and be committed to the game, your team and your club. 

6).   Be a ‘good sport’. Applaud all good play whether by your team or the opposition. 

7).   Respect your opponent. Treat all players as you would like to be treated. Do not ‘bully’ or take advantage of any player. 

8).    Rugby is a team sport and make sure you co-operate with your coach; team mates and members of your club. 

9).    Remember that the goals of the game are to have fun, improve your skills and feel good. 

10).  At the end of the match thank your opponents and the referee for the match. 

11).  Always remember that you owe a duty of care to your opponents. Tackle hard but fairly; do not intend to hurt your opponent.

12).  Winning and losing is part of sport: Win with humility – lose with dignity. 

13).  As part of the team it is important that you attend training regularly and listen to your coach and help your team.

14).  As a team sport it is important to understand that all members are important to the team!

15).  Remember you are representing your team, club, family and the Game of Rugby.



 In line with club policy, no player will be allowed to train or represent Buccaneers rugby club after the 31st of October 2015 if their subscription is not paid.





Insurance coverage in the form Group Personal Accident Scheme for Clubs arranged by the IRFU and issued by Aviva Insurance limited is included as part of your membership.  A summary of the terms and conditions of the policy is posted on the club noticeboard / website.


 The Executive Committee and the Club draw your attention to the terms, conditions and limitations of the policy and advise that additional coverage should be sought if required.  Additional Voluntary Top-Up cover is available directly from the IRFU's insurance brokers, AON and through many schools.  


I have read the above and accept the terms and conditions including the terms and conditions of the policy offered.


SIGNED ______________________   DATE ________________________                       



PARENTAL CONSENT                            


I [PRINT NAME] _________________________ parent or guardian of the above named Age-Grade player have full authority and hereby consent to his/her participation in club activities and to receive appropriate information through text, email and social media.  I acknowledge that the club is not responsible for providing adult supervision except for formal age-grade coaching, matches and competitions.  If selected on representative teams, I am satisfied my child will comply with IRFU and ISC anti-doping procedures and that the Union/Branch will receive all the relevant information contained on this form.  I authorise the club to make appropriate travel arrangements and understand that photographs/videos will be taken at or during rugby/club events and may be used for training, promotion of the game or otherwise where approved by the Club Executive. 

I have read and agree to abide by the IRFU Parent's Code of Conduct and I agree that my child will abide by the Age-Grade Player's Code of Conduct.


SIGNED ______________________  DATE ________________________




LEPRACHAUNS                                         (Age 7 and Under)                                      €40

MINI PLAYER                                               (Age 8 – Age 12)                                         €70

YOUTHS & FULL TIME STUDENTS           (U13s – U19s)                                        €80

ADULT / ADULT PLAYER                          (U20s – Senior)                                         €120


FAMILY (Parents & Children U18)                                                    

With 2Players                                                                                                           €120  

With 3             Players                                                                                               €160                         


(Separate form available on request)  SINGLE  €180          FAMILY  €200              PENSIONERS      €140

Special offer:- 5 years Pirates Membership only €1,000…...and get 6th year FREE!


Completed forms together with the appropriate fee should be returned to Team Manager or our Administrator Geraldine Kenny at the Club – 086 1732711 or 

Credit Card Payment     Contact Geraldine on 086 1732711

Cheques payable to Buccaneers