SCYR New Club Application
Thank your for you helping to grow rugby in Southern California!

Please submit the following information for review. A key consideration in the process is practice and game field locations of the new club and the geography that players will be recruited from. Not being in conflict with existing clubs is vital. Once your application has been reviewed, SCYR will follow up to ensure the club has the correct infrastructures in place before moving forward.

Application Deadlines for 2019/20 seasons:
Club U8-U12, BU14: October 1, 2019
Club BU16-18, GU15-GU18: December 20th, 2019
Club Information
Proposed Club Name *
Club Names must be approved
Your answer
Are you a 501(c)3? *
Non-profit organization
If no, do you intend to become a 501(c)3? *
Club Location *
City and Field Location
Your answer
Club Mailing Address *
For USAR information requirements
Your answer
Club Philosophy/Major Goals *
Please briefly describe why you wish to start this club and what you hope to achieve in the short and long terms.
Your answer
Team Information
Proposed Team Nickname *
Nicknames must be approved
Your answer
Proposed Team Colors *
Your answer
Age Groups *
Check all that apply
Required
Competitive Season(s) *
Check all that apply
Required
Do you have a Level 200 Certified coach for each contact team you intend to run? *
Check all that apply
If Yes, who? *
Please list first and last names of all intended coaches.
Your answer
Are all your coaches Level 200 Certified? *
Check all that apply
If no, what is your plan for putting all contact coaches through Level 200 certification? *
Note: SCYR requires that all coaches working with contact teams have completed their Level 200 certification. Please note if you need assistance with scheduling or finding a Level 200 course for your coaches
Your answer
Are all your coaches currently registered and in good standing with USA Rugby? *
Note: SCYR requires that all coaches working with SCYR teams are registered and in good standing with USA Rugby.
Contact Information
Primary Contact Name *
Your answer
Primary Contact Email *
Your answer
Primary Contact Phone *
format: 1234567890
Your answer
Primary Contact CIPP#
If previously registered with USAR
Your answer
Primary Contact role(s): *
Select all that apply
Required
Primary Contact Recent Rugby History *
Please list all rugby programs you have worked with recently at any level (youth, HS, collegiate, adult, select side) and include your role for each organization.
Your answer
Primary Contact Recent Rugby References *
Please at least one contact (name, email and cell) for any rugby programs you have worked with recently at any level (youth, HS, collegiate, adult, select side).
Your answer
Secondary Contact Name
Your answer
Secondary Email
Your answer
Secondary Phone
format: 1234567890
Your answer
Secondary Contact role(s):
Select all that apply
Secondary CIPP#
Your answer
Secondary Contact Recent Rugby History *
Please list all rugby programs you have worked with recently at any level (youth, HS, collegiate, adult, select side) and include your role for each organization.
Your answer
Secondary Contact Recent Rugby References *
Please at least one contact (name, email and cell) for any rugby programs you have worked with recently at any level (youth, HS, collegiate, adult, select side).
Your answer
Anything else we should know?
Your answer
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