Rotary Club Contact Rotary Club Name Email Phone Applicants must be 18 years old or over on 1st September 2026 RYLA Candidate Name Email Address Phone Contact Address Post Code Gender SelectMaleFemale Date of Birth Can you swim? SelectYesNo Medical & Personal Information Do you have any disabilities or medical conditions to declare? Any allergies or special dietary requirements? Any other information or special requests? Place of Work or Study Type of Work or Study Emergency Contact Details Name Relationship Email Phone I confirm that I am committed to attending the full week of the course. Signature of Candidate (type full name) Date Submit Application
