TRIAL OJR RUGBY Please complete the form below to register for a trial. Full Name* Email* Mobile Number* Course* Age* Date of Birth* Gender*MaleFemale Height (cm)* Weight (kg)* Year of Study* FoundationFirstSecondThirdMScOther Number of Years Playing Rugby* Less than 1 Year1 - 2 Years3 - 4 Years5+ Years Previous Club/School* 1st Playing Position* Loosehead PropHookerTighthead PropSecond Row678Scrum HalfFly HalfInside CentreOutside CentreWingerFullback 2nd Playing Position* Loosehead PropHookerTighthead PropSecond Row678Scrum HalfFly HalfInside CentreOutside CentreWingerFullback Emergency Contact (Name)* Emergency Contact (Phone Number)* School / Club Contact Name School / Club Contact Phone Number School / Club Contact Email* Please state any medical conditions that we should be aware of You need to enable Javascript for the anti-spam check.
