Please complete the following form to register for the clinic below:  


City: Langford - Girls Youth Clinic, BC
Association: Rugby Canada
Date & Time: Apr 16/14 @ 6:00 pm-Apr 16/14 @ 7:30 pm
Location: Rugby Canada Centre of Excellence
Contact: James Kent
Cost: $25.00


* Player First Name:
* Player Last Name:
* Parent Name:
* Parent Phone:
* Parent email:
* Emergency Contact:
* Emergency Contact Phone:
* Player Grade:
* Player years of rugby experience:
* Agree to Waiver?:   click here to read waiver

* required



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email: dhopkins@rugbycanada.ca Voice: 250-418-8998