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Off Season Program Info
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Home
Rugby Sevens
Off season program
Off Season Program Info
Book Here
Holiday Clinics
Next Holiday Clinic Dates
Holiday Clinic Packs
FAQ
Book Now
About Us
Sponsors
Info about our staff
Info about Alleygators
Terms of Participation
Privacy Policy
Contact
Academy Blog
Home
Rugby Sevens
Off season program
Off Season Program Info
Book Here
Holiday Clinics
Next Holiday Clinic Dates
Holiday Clinic Packs
FAQ
Book Now
About Us
Sponsors
Info about our staff
Info about Alleygators
Terms of Participation
Privacy Policy
Contact
Academy Blog
Book Now
Parent / Carer Details
Name
*
First
Last
Parent / Carers Contact Number
*
Parent / Carers Email
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
No of Children attending
1
2
3
4
Player 1 Details
Is your child a returning player?
*
Yes
No
Holiday Clinic Date
*
-- select --
U6 – U13's - combined: Tuesday 24th September 9.00am – 3.00pm
Girls Rugby day: Wednesday 25th September 9.00am – 3.00pm
Name
*
First
Last
DOB
*
Gender
*
Male
Female
Name of Junior Rugby Club your child plays for
What School does your child attend?
Does your child have any illnesses, allergies or injuries we should know about? Please provide details...
*
T-shirt size
*
Fill in the column. EG: Girls 12. Sizes come in: Junior - 6 8 10 12 14 | Senior - XS S M L XL 2XL
Player 2 Details
Is your child a returning player?
*
Yes
No
Holiday Clinic Date
*
-- select --
U6 – U13's - combined: Tuesday 24th September 9.00am – 3.00pm
Girls Rugby day: Wednesday 25th September 9.00am – 3.00pm
Name
*
First
Last
DOB
*
Gender
*
Male
Female
Name of Junior Rugby Club your child plays for
What School does your child attend?
Does your child have any illnesses, allergies or injuries we should know about? Please provide details...
*
T-shirt size
*
Fill in the column. EG: Girls 12. Sizes come in: Junior - 6 8 10 12 14 | Senior - XS S M L XL 2XL
Player 3 Details
Is your child a returning player?
*
Yes
No
Holiday Clinic Date
*
-- select --
U6 – U13's - combined: Tuesday 24th September 9.00am – 3.00pm
Girls Rugby day: Wednesday 25th September 9.00am – 3.00pm
Name
*
First
Last
DOB
*
Gender
*
Male
Female
Name of Junior Rugby Club your child plays for
What School does your child attend?
Does your child have any illnesses, allergies or injuries we should know about? Please provide details...
*
T-shirt size
*
Fill in the column. EG: Girls 12. Sizes come in: Junior - 6 8 10 12 14 | Senior - XS S M L XL 2XL
Player 4 Details
Is your child a returning player?
*
Yes
No
Holiday Clinic Date
*
-- select --
U6 – U13's - combined: Tuesday 24th September 9.00am – 3.00pm
Girls Rugby day: Wednesday 25th September 9.00am – 3.00pm
Name
*
First
Last
DOB
*
Gender
*
Male
Female
Name of Junior Rugby Club your child plays for
What School does your child attend?
Does your child have any illnesses, allergies or injuries we should know about? Please provide details...
*
T-shirt size
*
Fill in the column. EG: Girls 12. Sizes come in: Junior - 6 8 10 12 14 | Senior - XS S M L XL 2XL
In an emergency, do you authorise the Southern Cross Rugby to arrange any necessary medical treatment for your child/ren where contact with yourself or nominated contact are unavailable?
*
Yes
No
How did you hear about Southern Cross Rugby?
*
Yes, I agree to Terms and Conditions
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