Parent/Guardian Agreement for an Under 18 Player to play Senior Men’s Rugby
Any player who is Under 18 years of age as at 1 January must complete this form in order to be able to play Senior Rugby.
Process:
• This form must be submitted to the MRU by a Club Captain prior to the player taking the field of play.
• Wherever possible, the MRU will approve/deny the dispensation based on the application.
• In some cases the MRU will need to view the player. In this case, the Club will be informed and a pending
dispensation granted until viewing has taken place.
Dispensation Grade Request (Which grade does the player wish to play):
Player’s Details:
Full name:
____________________________
Club:__________________________________
DOB:
__________/_________/________
Age as at 1st January 2017:
__________
Grade played in 2016:
__________
Number of seasons playing rugby: _________
Dispensation Details:
Reason for dispensation:
Please explain:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Club Captain’s / President’s signature:
Name: _________________________
Signature: _________________________ Date:_______/_______/_______
Parent/Guardian signature:
Name: _________________________
Signature: _________________________ Date:_______/_______/_______
Submit this form to:
Manawatu Rugby Union, P O Box 1729, Palmerston North
Fax: (06) 354 1670, Email: [email protected]