Women's 1st XV Registration for Assessment

Your Details

These details are for you, the Player which will be used by the County administrators.

First Name(*)

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Last Name(*)

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Rugby Club

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Club Coach

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Your RFU Registration Number

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About Your Rugby

Please tell us your first and second playing position preferences.

Have you been selected for/played in an AP15s or Premiership Cup match this season?(*)

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Email Address(*)

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Current Address 1(*)

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Address 2

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Town / City(*)

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Post Code(*)

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Home Tel. No.

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Mobile Tel. No.(*)

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Town of Birth(*)

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Date of Birth - you must be over 18 years of age(*)

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Emergency No(*)

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Gender(*)

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Your Medical History(*)

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The Surrey Women's County Programme Assessment Day

The assessment will take place on

Monday 27th March 2023 at Imber Court. The assessment will begin promptly at 7.00pm.

If you cannot attend that day then choose 'I can't make that date' and we will contact you with a later alternative date that is yet to be arranged.

Attendance confirmation(*)

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(*)

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Submit

Surrey Women County Player Registration

Your Details

About Your Rugby

The Surrey Women's County Programme Assessment Day

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