Smart Rugby Online Registration Saturday 6th June, 2020 9:30am-11:30am approx.
Please complete the form below
Full Name
*
First Name
Last Name
Rugby Xplorer ID Number
My Rugby ID Number used as Login for Rugby Xplorer
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Date of Birth
*
-
Day
-
Month
Year
Date Picker Icon
Do you identify as Aboriginal or Torres Strait Islander
Yes
No
Other Information:
Primary Role
*
Coach
Match Official
Volunteer/Other
Region/Association
*
AIC Schools
Brisbane Junior Rugby Union
Central Highlands Rugby Union
Downs Rugby
FNQ Rugby Inc
Gold Coast & District Rugby Union
GPS Schools
Hervey Bay JRU
Mackay Rugby Union Inc
Mt Isa Rugby Union
Queensland Premier Rugby
Queensland Suburban Rugby Union
Rugby Bundaberg
Rugby Capricornia Limited
Sunshine Coast Rugby Union
TAS
Townsville & District RU
Western Queensland Rugby Union
Club
Eg; Norths Rugby Union
School
(If you are a school coach)
Have you previously been Smart Rugby certified?
YES
NO
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