VIRGINIA RUSH PENINSULA PLAYER TRYOUT REGISTRATION
Please fill out the form in full to provide VA RUSH your contact and player data. If you are unable to attend our tryout dates but interested in an assessment please indicate that below and upload your players information.  
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Player Name *
Player Date of Birth *
MM
/
DD
/
YYYY
Gender *
Best Email Contact *
Home Address *
Cell Phone number *
Emergency Contact Name *
Emergency Contact Number *
Current/Last Club Affiliation (or league) *
Please include date you will attend tryout? *
Required
What is your position preference? *
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