Girls Rugby PA Clinic Registration

Girls Rugby PA Clinic Registration

Use this form to register for your upcoming Girls Rugby clinic. All clinics will be indoor and at South Hanover Township Community Building. Questions? Please contact us at pennsylvania@girlsrugbyinc.com.
Player Name *

First Name Last Name
Current Grade Level *
T-Shirt Size *
Please indicate your rugby experience (Select all that apply) *

This is my first time! (I'm super excited!) I've tried rugby before, but I've never played in an official program I've played flag rugby before I've played contact rugby before
Parent/Guardian Name *

First Name Last Name
Contact Email *
example@example.com
Phone Number *

Area Code Phone Number
PARTICIPATION WAIVER
Participation Waiver - Please review our Participation Agreement prior to participation. Do you consent to waiver for the Girls Rugby event? *

Yes, I consent
MEDIA RELEASE FORM
Media Release - Please review our Media Release prior to participation. Do you consent to this media release for the Girls Rugby event?

Yes, I consent
Girls Rugby PA - Winter Indoor Clinics

All clinics will be indoors at the South Hanover Township building in the Community Room. Clinics will be 2 hours in length and include a t-shirt with registration. Sign up for multiple clinics to save!
Which clinics are you signing up for? (Select all that apply) *

November 20th - 1-3pm January 22nd - 1-3pm February 19th - 1-3pm March 19th - 1-3pm
Clinic Registration - Select only the amount for the total number of clinics you will attend. *
prev next ( X )
$35 - 1 Clinic $ 35.00
Includes t-shirt in price.

$50 - 2 Clinics $ 50.00
Save $20 when signing up for 2 clinics.

$75 - 3 Clinics $ 75.00
Save $30 when signing up for 3 clinics.

$100 - 4 Clinics $ 100.00
Save $40 when signing up for all 4 clinics.

Total $ 0.00
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Girls Rugby PA Clinic Registration

Girls Rugby PA - Winter Indoor Clinics