Alexandria Rugby Home

2010 Prospective Player Registration

* Required Field

 Mayor's Cup Home
*Full Name:
Address:
Address:
City:
State: Zip Code:
*Primary Phone:    
Secondary Phone:
*E-mail Address:
USA Rugby CIPP No.:  
*Age:   Date of Birth: (mm/dd/yy)
Height:        Weight:  
*Position: Total Years Played:
Specialty: Total Years Played:
*Current Club:
References and Additional Personal Information to help us know you better:

 

 
 
 
 
 
 
 
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P.O. Box 26244| Alexandria, VA | 22313