Past Players Registration Details

Please use this form to enter your personal details if you would like to register as a past player or non playing member of Centaurs R.F.C.

The form may also be used by existing members to:

  1. notify any change of details,
  2. request a Standing Order Mandate in order to join the 100 Club
  3. request a change of pass-code.

Please enter your name:

First Name
Last Name

Are you an existing or new member? (please select):


(If an existing member please only enter details that have changed)

Address: 
             
             
             

Post Code:

Home Phone No.:

Business Phone No./Ext:

Fax No:.

E-Mail:

Date of Birth  (dd/mm/yy):

Check box if you are still playing for Centaurs  

Pass-code:

Would you like to join the 100 Club ?

Yes No

If Yes, how would you like the Standing Order Mandate sent to you?:


Copyright © 2001 Mount Business Systems. All rights reserved.
Revised: January 06, 2001