PR7s Portland Camps
Train with the best at PR7s' 5-Week Portland Camps
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Session 5 - Youth Flag Rugby Festival
Saturday, May 3
$
45.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Participant Information
Participant's Name
*
First Name
Last Name
Participant's Date of Birth
*
-
Month
-
Day
Year
Date
Participant's Grade
Please Select
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Participant's Email
*
example@example.com
Participant's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Shirt Size
*
Please Select
XS
S
M
L
XL
Years of Rugby Playing Experience
*
Current Club or School Team
Current Coach's Name
First Name
Last Name
Current Coach's Email
example@example.com
Does the participant have any allergies?
*
Does the participant have any medical needs our medical staff should be aware of?
*
CIPP Registration Number (if applicable)
Please upload a photo of the participant's medical insurance card
*
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Parent/Guardian Information
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Home City & State
*
Example: Kanas City, MO
Emergency Contact Name (if different from above)
First Name
Last Name
Emergency Contact Phone Number (if different from above)
Please enter a valid phone number.
Format: (000) 000-0000.
If traveling from out of town, are you interested in receiving information on group hotel rates?
*
Yes
No
Required Forms
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