Please note: Age Grade Male Fixture Secretary & Assistant Age Grade Male Fixture Secretary roles/contact details on GMS need to be up-to-date on the system, as this will be used as point of contact for this competition.

Questions marked with a * are mandatory and must be completed before submission.

If there are queries regarding this entry form then please email competitions-development@rfu.com

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* 1. Club Name*

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* 2. Main Contact Name*

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* 3. Main Contact Mobile Number*

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* 4. Main Contact Email Address*

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* 5. Main Contact GMS Role

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* 6. Club Post Code*

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* 7. Kit Colour*

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* 8. Alternative kit colour

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* 9. Local Constituent Body (CB)*

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* 10. Region*

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* 11. Competition Participating in usually

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* 12. Upload of Head Case Certificate:

The RFU, our national Constituent Bodies and partners are determined to ensure that we lead the way in keeping the welfare of our players at the forefront of all we do.

Thus, as part of your involvement in the 2019/20 National U18s Cup, we would like you to commit to a two-step Concussion Education Code as follows in your club:

• All staff coaching or refereeing contact rugby to have successfully completed the 30-minute Headcase Concussion Awareness Course for Youth Coaches available here.

• All players to have been signposted to the Headcase Concussion Awareness programme here.

We believe your application to enter the National U18s Cup is your commitment to deliver this code.

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