Kent Rugby - Women's Registration Form - Medical
This is the 2nd of 4 Google forms sent to you.

Player welfare is important to the coaches and comittee of Kent Women, and paramount to the players safety and development. Please take the time to complete this form fully. Please watch the embedded concussion video also.

If you have any questions between now and then please contact Kent Womens Secretary, Graham Bloxham via kentwomensrugbysecretary@gmail.com

Name *
Your answer
Medical information (any medical conditions and/or current/reoccuring injuries) If none, write N/A *
Your answer
Other relevant medical information (including allergies and dietry requirements) If none, write N/A *
Your answer
Understanding Concussion video:
Player welfare is of paramount importance to Kent Rugby, please watch the following 7-8 minute video and click the confirmation box below.
Understanding Concussion *
Required
EMERGENCY CONTACT DETAILS
If player is under 18years of age, this person MUST be a parent/guardian
Emergency contact's name *
Your answer
Emergency contact's relationship to player *
Your answer
Emergency contact's telephone number *
Your answer
Submit
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