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The Rocks Rugby Winter 2026 Interest Form 
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Parent/Guardian First & Last Name *
Athlete First & Last Name *
Athlete Date of Birth? *
MM
/
DD
/
YYYY
What school does the athlete attend? *
What grade is the athlete currently in? *
What age division are you enrolling the athlete? *
Are you enrolling siblings? 
(Please fill out form for each child separately)
 *
If yes to sibling enrollment, please write the sibling first and last name. 
If not applicable  please write "N/A"
 *
Does your athlete have any medical conditions we should be aware of? If no type "N/A" *
Does your athlete require an inhaler, EpiPen, or other emergency medication?  If no type "N/A" *
Does your athlete have any physical or mobility limitations? *
What is the parent/guardian email? *
Phone number  *
Emergency Contact First & Last Name *
Emergency Contact Phone Number *
Would you like updates about registration and season details? *
The Rocks Rugby occasionally posts photos/videos of players to celebrate the kids and promote the program. Do you allow us to include your child in these images? *
Do you qualify for any discounts? *
Would you like information about hardship assistance? *Please note, slots are limited* *
Are you interested in volunteering this season? 
(You can select more than one)
 *
Required
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