Legal First Name *

Preferred First Name *

Last Name *

Email *

Phone *

Date of Birth *

(MM/DD/YYYY)

Gender

Female

Male

Have you ever registered with a USARL affiliated team?

Yes

If yes, which team?

Do you have a passport? *

Yes

If yes, what date does your passport expire?

(MM/DD/YYYY)

How do you plan to fund the player portion of the trip?

Are you committed to practicing 2 times per week leading up to the tournament with the team?

Yes

Rugby League Experience

I agree to terms & conditions provided by URLA and USARL. By providing my phone number, I agree to receive text messages from URLA.