HomeLogo
Home
Play Rugby
Support
About
Our Community
Our Leadership
Contact
Members
Shop
HomeLogo
Home
Play Rugby
Support
About
Our Community
Our Leadership
Contact
Members
Shop
Registration
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Pronouns
Phone
*
Email
*
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Select Activity
*
Rugby 101
Pre-Season Training
please select one
*
I am able to pay $40.00 now
I need financial assistance, please
Shirt Size
*
XS
S
M
L
XL
XXL
3XL
Past Experience
*
None
Played Other Sports
Played Rugby (detail below)
If you have played rugby, please provide details of your past experience, including position and/or past club affiliation.
Agreements (check all boxes)
*
I meet the health/vaccination requirements — or will by the time I attend practice.
I am a resident of the state of California — or will be by time I attend practice.
I agree to allow my likeness to be featured in print, social, visual or video media.
I understand and agree to uphold the Rebellion’s principles of inclusion.
Payment
*
Submit
