Player information sheet

Player Information Form

Name *

First

Last

Email address *

Home address *

Home town and state *

Cell phone *

Major *

Student ID Number *

Date of birth *

Emergency contact information - primary contact *

Emergency contact information - secondary contact *

High school *

Year your class graduated from high school *

Previous rugby or other sports experience *

List any current or previous injuries, illnesses, allergies or other health concerns *