Jr Pandas Rugby Registration Form
Fall 2025
Assessment Date: Monday Sept 8, 2025
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Last Name *
First Name *
Birth date **Please ensure the YEAR is correct** *
MM
/
DD
/
YYYY
Athlete Email Address *
Athlete Phone Number *
Emergency Contact Information - Parent/Guardian Name *
Emergency Contact Information - Parent/Guardian Email *
Emergency Contact Information - Parent/Guardian Phone Number *
Grade (as of Sept 2025) *
Current School *
Club Team *
Preferred Position *
Secondary Position *
Past Rugby Experience *
Submit
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