Belmont Rugby - 2021 Boys Sign Up

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Which team are you signing up for? *

Boys

Girls

Enter your LAST NAME *

ex: Berens or Wu

Enter your FIRST NAME *

ex: Timothy or Allison

Enter your GRADE *

9th Grade

10th Grade

11th Grade

12th Grade

Enter your EMAIL ADDRESS: *

This is the email address at which YOU will receive team emails - it will be added to the Belmont Rugby Team Email List.

2021 QUESTION - Have you ever been diagnosed with Covid-19? *

If you put an email address here - it will be added to the Belmont Rugby Family Email List.

Yes

IF YOU ANWERED YES - to the previous question. Have you submitted a medical clearance from a doctor to the nurses office?

This is a requirement for students with a positive Covid test on file.

Yes

Clear selection

Enter your PARENT/GUARDIAN #1's name: *

Enter your PARENT/GUARDIAN #1's phone number: *

Please share the number at which a guardian can be reached in case of an emergency.

Enter your PARENT/GUARDIAN #1's email address: *

This email address will be added to the Belmont Rugby Family Email List.

Enter your PARENT/GUARDIAN/EMERGENCY CONTACT #2's name: *

Enter your PARENT/GUARDIAN/EMERGENCY CONTACT #2's phone number: *

Please share the number we will ONLY use if we can't reach your parent/guardian #1 in case of an emergency.

OPTIONAL - Enter your PARENT/GUARDIAN #2's email address:

If you put an email address here - it will be added to the Belmont Rugby Family Email List.

Are you a New Player this year or a Returning Player?

New Player in 2020

Returning Player in 2020

Clear selection

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