Register a Club

Registering an existing club?

Please complete the registration form below.

Are you registering a brand new club? *

Yes No
Club name *
Date Club was Established *
Email Address *
Website URL
Location of Club *
Please select your nearest Council *
Please upload your club patch *
Select Image
Keyholder name 1 *

First

Last
Position of Keyholder 1 *
Keyholder Name 2 *

First

Last
Position of Keyholder 2 *
Keyholder Name 3

First

Last
Position of Keyholder 3 *
Keyholder Name 4 *

First

Last
Position of Keyholder 4 *
Keyholder Name 5 *

First

Last
Position of Keyholder 5 *
Keyholder Name 6 *

First

Last
Position of Keyholder 6 *
Contact Person 1 name *
Position of Contact 1 *
Contact number *
Contact Person 2 name *
Position of Contact 2 *
Contact number of Person 2 *
*

You hereby acknowledge that by submitting this form, you agree to be listed on the MCRSA website.
*

I understand and agree with the Protocols ( I will contact MCRSA if I have any questions)