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* 1. Name:

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* 2. Date of Birth

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* 3. Email address:

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* 4. Have you played rugby before?

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* 5. Playing history ( if applicable):

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* 6. Preferred playing position (if applicable):

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* 7. Any medical conditions that coaching staff need to be aware of:

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* 8. Please select the dates which you are able to attend

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