JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
SoCal Youth Rugby New Club/HS Application
Thank your for growing rugby in Southern California! Please submit the following information for review.
Sign in to Google
to save your progress.
Learn more
* Required
Proposed Club/HS Name
*
Your answer
Your Name
*
Your answer
Your Email
*
Your answer
Your Cell
*
format: 1234567890
Your answer
Your role within the proposed new Club/HS:
*
Select all that apply
Administrator
Coach
Parent
Referee
Other:
Required
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 term.
Your answer
If no, do you intend to become a 501(c)3?
*
Yes
No
Already are
No, we are a High School
Club/HS Location and Address
*
City and Field Location
Your answer
Age Groups
*
Check all that apply
Youngers Club: U8 Co-ed Flag
Youngers Club: U10 Co-ed
Youngers Club: U12 Co-ed
Youngers Club: Bu14 Light
Youngers Club: Bu14 Open
Olders Club: Gu15
Olders Club: Bu16
Olders Club: Bu18
Olders Club : Gu18
HS Boys 15s
HS Boys 7s
HS Girls 15s
HS Girls 7s
Required
Do you have a Level 200 Certified coach for each division noted?
*
Check all that apply
Yes
No
If Yes, who?
*
Please list first and last names of all intended coaches.
Your answer
Are your coaches currently registered and in good standing with USA Rugby?
*
Yes
No
In Process
Is anyone within the new proposed Club/HS a Certified Referee?
*
Yes
No
If so, what is the ref's name?
Your answer
Your 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
Your 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
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms