Rugby NorCal Club Info Form

Date

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Club Name:

Club Mailing Address:

Primary Contact Name:

Primary Contact Title:

Primary Contact Email:

Primary Contact Phone:

Primary Field Name:

Primary Field Address:

Club Registrar Name:

Club Registrar Email:

Club Registrar Phone:

Spring Break Dates:

Select All Teams:

Boys High School Varsity Boys High School JV Girls High School Boys Middle School Girls Middle School U12 U10 U8

Fill out info for all teams and click submit at the bottom.

Team 1:

Head Coach Name:

Head Coach Email:

Head Coach Phone:

Head Coach CIPP #:

Assistant Coaches/Admin: Name, Email, Phone, CIPP #

Affiliated Referee Name:

Affiliated Referee Email:

Affiliated Referee Phone:

Affiliated Referee CIPP #:

Team 2:

Head Coach Name:

Head Coach Email:

Head Coach Phone:

Head Coach CIPP #:

Assistant Coaches/Admin: Name, Email, Phone, CIPP #

Affiliated Referee Name:

Affiliated Referee Email:

Affiliated Referee Phone:

Affiliated Referee CIPP #:

Team 3:

Head Coach Name:

Head Coach Email:

Head Coach Phone:

Head Coach CIPP #:

Assistant Coaches/Admin: Name, Email, Phone, CIPP #

Affiliated Referee Name:

Affiliated Referee Email:

Affiliated Referee Phone:

Affiliated Referee CIPP #:

Team 4:

Head Coach Name:

Head Coach Email:

Head Coach Phone:

Head Coach CIPP #:

Assistant Coaches/Admin: Name, Email, Phone, CIPP #

Affiliated Referee Name:

Affiliated Referee Email:

Affiliated Referee Phone:

Affiliated Referee CIPP #:

Team 5:

Head Coach Name:

Head Coach Email:

Head Coach Phone:

Head Coach CIPP #:

Assistant Coaches/Admin: Name, Email, Phone, CIPP #

Affiliated Referee Name:

Affiliated Referee Email:

Affiliated Referee Phone:

Affiliated Referee CIPP #:

Team 6:

Head Coach Name:

Head Coach Email:

Head Coach Phone:

Head Coach CIPP #:

Assistant Coaches/Admin: Name, Email, Phone, CIPP #

Affiliated Referee Name:

Affiliated Referee Email:

Affiliated Referee Phone:

Affiliated Referee CIPP #:

Team 7:

Head Coach Name:

Head Coach Email:

Head Coach Phone:

Head Coach CIPP #:

Assistant Coaches/Admin: Name, Email, Phone, CIPP #

Affiliated Referee Name:

Affiliated Referee Email:

Affiliated Referee Phone:

Affiliated Referee CIPP #:

Team 8:

Head Coach Name:

Head Coach Email:

Head Coach Phone:

Head Coach CIPP #:

Assistant Coaches/Admin: Name, Email, Phone, CIPP #

Affiliated Referee Name:

Affiliated Referee Email:

Affiliated Referee Phone:

Affiliated Referee CIPP #:

Team 9:

Head Coach Name:

Head Coach Email:

Head Coach Phone:

Head Coach CIPP #:

Assistant Coaches/Admin: Name, Email, Phone, CIPP #

Affiliated Referee Name:

Affiliated Referee Email:

Affiliated Referee Phone:

Affiliated Referee CIPP #:

Team 10:

Head Coach Name:

Head Coach Email:

Head Coach Phone:

Head Coach CIPP #:

Assistant Coaches/Admin: Name, Email, Phone, CIPP #

Affiliated Referee Name:

Affiliated Referee Email:

Affiliated Referee Phone:

Affiliated Referee CIPP #: