2025 Rugby Skills International Registration Camp Form

Rugby Skills International Academy Clinic 2025

Snap Advanced Clinic 9-11 April, 2025, Rockhampton, led by legend Brad Thorn.
This is your chance to train with one of the greats, sharpen your skills, and take your game to the next level with our Snap Advanced Clinic, led by rugby league and rugby union legend Brad Thorn! 🏉🔥

This intensive three-day clinic will take each player's game to the next level and set them up for rep programs. In addition, they will make life-long friendships.

Age group: 13-19 years

Boys and girls

Those aged 12 years will be selected by coaches only.

This is an opportunity for each player to be professionally coached and will learn our point of difference.

The Snap Advanced Course will cover:
- 15s content
- 7s content
- Systems - attack and defence
- Functional role
- Role clarity
- Execution under pressure and under fatigue
- Micro-skills
- Video analyst
- A personal player's diary
Delivering specialist skills will be:

Brad Thorn: specialist forwards Tight 5, scrum, ruck, maul, lineout, defence.

Junior Poluleuligaga: back attack specialist, inside backs 10 & 9 halfback, Sevens content.

Donny Mill: Sevens content, core skills executions.

Onehunga Matau'iau: front row specialist, hookers, core skills executions and systems.

This is a daily clinic over three days.

When: Wednesday, Thursday and Friday 9-11 April

Time: 8.30am to 3pm each day

Where: Colts Rugby Union Club, Rockhampton (the club will run a canteen each day, where lunch can be purchased)
The cost of the three-day intensive clinic is $950 including GST.

To confirm your son or daughter's place in this camp, you are required to pay a $475 as a deposit. A payment schedule is outlined below:

March 26 - $475 (deposit)

April 2 - $475 (final balance)

Please make the payment to the details below, and label the payment with Camp and the player's surname.

Email your payment receipt to rugbyskillsqld@gmail.com.

Rugby Skills Academy Pty Ltd

BSB: 064-129

Account: 1068 2347

Reference: Camp Surname

Full payment is required by April 2.

Want to pay by credit card?

You can choose to pay for the camp by credit card, but there is a 2.2 per cent surcharge, which brings the price to $970.90.

If you wish to proceed with this option, the details are below.

Please note if you wish to cancel, there will be a cancellation fee of $110.

My Products

International Camp$970.90AUD

Credit Card

Player Information - registration
Player's Name

First NameLast Name
Birth Date

MonthDayYear
Gender

MaleFemale
Age group

Under 13Under 14Under 15Under 16Under 17Under 18Under 19
Position played
Highest level of representative rugby played
Address

Street Address

Street Address Line 2

CityState / Province

Postal Country
Parent/Guardian Information
Name

First NameLast Name
Home Number

Area CodePhone Number
Mobile Number

Area CodePhone Number
E-mail
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
General medical history
Is the player up-to-date with immunisations?

YesNo
Last date of tetanus vaccine
Does the player have any allergies, chronic illness, or medical conditions? If yes, please describe.
Does the player have any prescribed medication?

YesNo
List any medication taken regularly.
Has the player had any operations? Please list.
Will training aggravate the player's condition?

YesNo
Medicare and medical insurance details
Medicare number
Name on card
Private health fund
Health fund number
Does the player have any special dietary needs, eg Diabetes?

YesNo
Does the player have any food allergies?

YesNo
Please list what foods the player is allergic to eg peanuts, treenuts, cow's milk, egg.
For player's with other dietary needs, please list the requirements here.
Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Rugby Skills Academy (referred to as The Academy) during the selected camp. In exchange for the acceptance of said child’s candidacy by The Academy. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless The Academies and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions.

In case of injury to said child, I hereby waive all claims against the Academy. including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including rugby. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
I understand and accept the above

Yes
Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to The Academy and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.
I understand and accept the above

Yes
Photo release

Rugby Skills Academy has my permission to use my or my child’s (named above) photograph publically to promote the library. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
I have read and accepted this

YesNo
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty:

Rugby Skills International Academy Clinic 2025

Credit Card

General medical history

Medicare and medical insurance details