Season Commitment

Club Membership Registration – Temporarily Unavailable

We’re updating our club membership registration process and policies for the 2026–27 season.

New registrations and dues payments are temporarily paused while we finalize these updates.

Please check back soon. Thanks for your patience!

DO NOT SUBMIT THIS FORM UNTIL:

• You have completed registration at USA Rugby

• If you require a 50% waiver as a full time student, are unemployed, and/or experiencing financial hardship, you must contact the Rebellion Club President

Name
Address
7 digits

I have reviewed the Rebellion Policies document *

Clear Signature
Signature

Health Insurance

No Known Allergens

Emergency Contact

Name

Payment

Payment
* Financial waivers require pre-approval from the President