All Abilities Rugby Registration Form

Please feel in the below form to register for an All Abilities Rugby Team

RugbyWA have three amazing clubs with All Abilities Teams, Southern Lions, Perth Bayswater and Wanneroo. The goal is to build an inclusive club setting for all people to enjoy the chance to play rugby and create lifelong friendships. It's safe, fun, and accessible for all abilities and experience levels. We would love you to come down and try rugby and become part of the rugby community.
⁠

Question Title

* 1. Player Name

Question Title

* 2. Email Address

Question Title

* 3. Phone Number

Question Title

* 4. Age of player

Question Title

* 5. Details:

Address

City/Town

State/Province

ZIP/Postal Code

Country

Question Title

* 6. Emergency Contact

Name

Email Address

Phone Number

Question Title

* 7. Club Preference

Perth Bayswater Rugby Club

Southern Lions Rugby Club

Wanneroo Rugby Club

Question Title

* 8. I consent to receive communication from RugbyWA & affiliated clubs

Yes

Question Title

* 9. How did you hear about All Abilities Rugby

Social Media

Shopping Centre Advert

Friend/ Family Member

School

Other (please specify)