SoCal Youth Rugby New Club/HS Application
Thank your for growing rugby in Southern California! Please submit the following information for review.

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Proposed Club/HS Name *
Your Name *
Your Email *
Your Cell *
format: 1234567890
Your role within the proposed new Club/HS: *
Select all that apply
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.
If no, do you intend to become a 501(c)3? *
Club/HS Location and Address *
City and Field Location
Age Groups *
Check all that apply
Required
Do you have a Level 200 Certified coach for each division noted? *
Check all that apply
If Yes, who? *
Please list first and last names of all intended coaches.
Are your coaches currently registered and in good standing with USA Rugby? *
Is anyone within the new proposed Club/HS a Certified Referee? *
If so, what is the ref's name?
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 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).
Anything else we should know?
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