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Neuqua Wildcats Rugby
Complete this form to receive information about Neuqua Wildcats Rugby. Note that no coach or administrator from Neuqua Wildcats Rugby will contact any student without including a parent, guardian, or other responsible adult.
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Student First Name
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Your answer
Student Last Name
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Your answer
Student Grade Level
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Freshman
Sophomore
Junior
Senior
Student email (Do not use District 204 email address unless that is your only email)
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Your answer
Parent / Guardian First Name
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Your answer
Parent / Guardian Last Name
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Your answer
Parent / Guardian email
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Your answer
Parent / Guardian Mobile Phone (for emergency)
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Your answer
Optional: 2nd Parent / Guardian First Name
Your answer
Optional: 2nd Parent / Guardian Last Name
Your answer
Optional: 2nd Parent / Guardian email
Your answer
Optional: 2nd Parent / Guardian Mobile Phone (for emergency)
Your answer
Optional: I found out about Neuqua Rugby from...
Referral from a current player or parent of a current player (please share the name below)
Social media
School communication (newsletter or announcement, etc)
Other (please share below)
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Optional: If referred by a current member - please share the name with us, or if you selected "Other" above, let us know how you found out about Neuqua Wildcats Rugby?
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