U16 Boys | North Island Tsunami Rugby

First Name *
Last Name *
Date of Birth (yy/mm/dd ex: 03/07/29) *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Gender *
School *
Player Phone *
Player Email *
Parent/Emergency Contact Name *
Parent/Emergency Contact Phone *
Parent/Emergency Contact Email *
Allergies/Injuries/Medical Conditions *
BC Care Card # (or alternate medical insurance info) *
Registered with Rugby Canada/BC Rugby/local club? *
yesno
Club affiliation
Shorts & shirt size *
These are adult sizes from Xtreme Rugby Wear.SMLXLXXL
Please list your rugby experience *
Please list 1-3 past or current coach references (name & email) *