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Ipswich Jets - 2023 U19's Expression of Interest
The Ipswich Jets are looking for all interested players to play for our QRL Harvey Norman U19's - Women's Team!
Players turning 17, 18, or 19 years next year are eligible to play in the Harvey Norman U19 Women's Competition.
It is a requirement the player be registered to play in the Ipswich rugby league competition.
Register your interest now to be part of this exciting representative rugby league team!
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Full Birth Name
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Your answer
Date of Birth
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MM
/
DD
/
YYYY
Address: Your current Residential Address.
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Your answer
Mobile Number: Must be current and connected.
Your answer
Email: Your best and current email address is required.
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Your answer
Emergency Contact: Who is your Emergency Contact? Please print full name.
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Your answer
Emergency Contact Phone Number
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Your answer
Emergency Contact Email Address
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Your answer
Emergency Contact: Relationship to you
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Mother
Father
Legal Guardian
Other:
Required
Education: Where are you attending High School?
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Your answer
Current Rugby League Club (That you have played for in the last three years)
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Your answer
Preferred Playing Position #1
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Fullback
Wing
Centre
Halves
Hooker
Middle Forward
Middle Edge
Preferred Playing Position #2
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Fullback
Wing
Centre
Halves
Hooker
Middle Forward
Middle Edge
Representative Experience: Please state any representative football (School or State) you have played.
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Your answer
Do you currently have any injuries that will prevent you from training in January 2023?
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Your answer
Have you had any major injuries or surgeries?
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Anything further you would like to tell us about you?
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