WIGAN-Community Rugby Camps A5 Flyer_Layout 1 08/03/2012 16:36 Page 1

WIGAN WARR IORS RUGBY CAMPS

Join the Community Foundation team, players and Mighty Max over the Easter holidays to learn the basic skills of through fun and games.

APRIL DAYS TIME VENUE AGE COST

Weds 4th Chorley Panthers ARLFC 2 9-3pm 6-14 Yrs Thurs 5th Chisnell Lane, Chorley, PR7 5EA £30

Tues Central Park 1 10-3pm 4-7 Yrs £15 10th Montrose Avenue, Pemberton, WN5 9XL £150 Per Team Max.15 players Thurs 12th Central Park 2 9-3pm 6-14 Yrs Fri 13th Montrose Avenue, Pemberton, WN5 9XL £30

TO BOOK CALL THE DW STADIUM TICKET OFFICE ON 0871 66 33 522 OR VISIT WWW.WIGANWARRIORS.COM WIGAN-Community Rugby Camps A5 Flyer_Layout 1 08/03/2012 16:36 Page 2

BOOKING FORM (PLEASE COMPLETE IN CAPITALS)

PERSONAL DETAILS (PARTICIPANT) FULL NAME

AGE ON CAMP D.O.B

ADDRESS

POSTCODE

DAYTIME TEL

EMERGENCY TEL

EMAIL

SCHOOL ATTENDED SEASON TICKET CLIENT CODE (IF APPLICABLE) CAMP VENUE CAMP DATES

SPECIAL REQUIREMENTS (MEDICAL / ALLERGY)

PAYMENT DETAILS

METHOD OF PAYMENT CREDIT / DEBIT CARD CHEQUE POSTAL ORDER

CARD TYPE VISA MASTERCARD ELECTRON SWITCH OTHER

NAME ON CARD ISSUE NO.

CARD NUMBER

VALID FROM EXPIRY DATE SECURITY NO.

TOTAL

PLEASE NOTE Full payment is required on booking. If returning by post, do not send cash, and return to: WIGAN WARRIORS RUGBY CAMPS, DW STADIUM, WIGAN, WN5 0UH All cheques and postal orders to be made payable to: Wigan Rugby League Club Ltd. Participants must enrol in advance as places are limited. Enrolments will not be permitted on the day. If you do not wish to receive further information from Wigan Warriors please tick this box I wish my son / daughter to be accepted on the course and I also give permission for Wigan Warriors to take and use photographs of my child for future publications and publicity, administer first aid and transfer my child to hospital if necessary. If you do not give consent for photographs of your child to be used tick here TO BOOK CALL THE DW STADIUM TICKET OFFICE ON 0871 66 33 522 OR VISIT WWW.WIGANWARRIORS.COM