Hornets Junior Rugby
2010 Registration Form

Player Surname: _________________________   
First Name: _______________________________________

Player Alberta Health Care Number: ______________________________ 

Player Email: ____________________________________

Parents/Guardian Name(s):_____________________________

Parent/Guardian Email: _________________________________

Home Phone: ____________________________________Parent /Guardian Cell Phone: ___________________________

Volunteer Position:

How did you hear about the Hornets or Rugby? _______________________School attended: _________­­­­­_____________

On occasion, pictures are taken of players during the games or at other rugby related events.  We often post these pictures on our website.  Are you willing to have your child’s pictures taken and posted on our website, or used in other promotional material?  Yes_______ No________

Parents Signature: _________________________________   Date:  ______________________________

__________________________________________________________________________________

To be completed by Hornets Registration: 

Rugby Canada Form Completed: _____   Received:  Socks: ____ T-shirt (U12/10/8 free) ____ other ___ other____

Amount paid:  $______________    Method: Cash ___Cheque___   Cheque number: ___________Tax Receipt: ____

If not paid in full: explanation: (i.e. $100.00 returning provincial team player)($25 new player intro)_____________________________

-------------------------------------------------------Tear off for player / parent------------------------------------------------------------

 Contact Information

Be sure to bring mouth piece; water bottle; rugby shorts; and proper footwear to every game and practice