Player Registration

Full Name

USA Rugby CIPP#

Date of Birth (YYYY-MM-DD)

Player Age

Address

Player Contact Number

Player Email Address

Player School

Player Grade

Player Weight

Player Height

Parent/Guardian Name

Parent/Guardian Contact Number

ECLIPSE REGISTRATION FEES

Youth Registration Fee $80.00

High School Registration Fee $100.00

Payment by Zelle 480-688-3659 to Chris Gray

If you are registering more than one player from the same family, contact Chris Gray for discount

ECLIPSE RUGBY FOOTBALL CLUB