QKJRU Registration Form 2021

Queensland Kiwi Junior Rugby Union | JUNIOR Trial Registration Form 2024
Player Information
Player's Name*

First NameLast Name
Birth Date*

DayMonthYear
Date
Gender*

MaleFemale
Age Group*
1st Preferred Position*
2nd Preferred Position*
What club/school do you currently play for?*
Do you have any injuries/medical conditions? If yes, please describe*
Parent/Guardian Information
Name*

First NameLast Name
Contact Number*
Email*
example@example.com
Uniform Order Form

Please be mindful. Sizes submitted will be used for players kits for the tournament in OCTOBER. Please ensure that you keep it in mind.
Uniform Order
Jersey Size (Half Chest Measurement)
Shorts Size (Waist to Fit)
Sock Size
Media Consent

By selecting submit, I give permission for my child‘s image to be used for promotional purposes for Queensland Kiwi Junior Rugby Union.

Informed Consent and Acknowledgement

By selecting Submit, I hereby give my approval for my child’s participation in any and all activities prepared by Queensland Kiwi Junior Rugby Union during the selection process and all games, tournaments after.

QKJRU TrialEach player trialing for the QKJRU is required to pay $10 to cover their insurance. (Non refundable).

$10.22AUD

Total

$0.00AUD

Queensland Kiwi Junior Rugby Union | JUNIOR Trial Registration Form 2024