SU Women's Rugby Availability Survey

General Info

Name*

First Last

Preferred Pronouns

Graduation Year*

Email*

Health

Height

Weight

Do you have any medical conditions, disabilities or allergies?

Yes

List each condition, disability or allergy and any medication you take for it:

Do you have any chronic injuries?

Yes

List your chronic injuries and what they may prohibit you from doing on the field:

Please check each box that applies to you:

Fainting

Dizzy Turns

Breathlessness or more easily tired than teammates

History of high blood pressure

Diabetes

Palpitations

Chest pain or tightness

Sudden death in your immedate family of anyone under 50

Smoking

Spring Availability

What practice days are you AVAILABLE to attend the ENTIRE training?*

Tuesday, 7:00-8:30p (Lally)

Thursday, 7:00-8:30p (Lally)

If you are unavailable any days, please list the reason. **If you will be LATE any days, please specify the day and reason + what time you will be arriving:

Please check the dates you are AVAILABLE TO ATTEND a tournament.*

Note: We will have 3-4 weekends of rugby. The purpose of this is to get an idea of any weekends we will not be able to field a side. This is not a commitment. Once we have the schedule in place we will request a final answer.

03/09

03/16

03/23

03/30

04/07 (Qualifier at St Bonaventure)

04/13

04/20

04/26 (Nationals in DC if qualified)

Attendance Policy Confirmation*

By checking this box you are assuring that you completely understand the SU Women's Rugby Attendance Policy. SUWRFC believes a balanced life makes better, happier players. Family, school & work are your top priorities. However, you are a member of a competitive team and are therefore accountable to your team. You are required to notify the team, prior to practice and through our digital attendance form, if you need to miss training unexpectedly due to family, school or work. An unexcused absence will prevent you from starting in the next match you are eligible to play. Multiple unexcused absences in one week will prevent you from playing in the next match you are eligible to play. --Please be responsible.--

SUWRFC Guideline Confirmation*

By checking this box you are assuring that you completely understand the SU Women's Rugby Guidelines.

By submitting this form I understand I will be contacted by SU Women's Rugby Club via email.