SU Women's Rugby Availability Survey

General Info

Name*

First Last

Preferred Pronouns

Graduation Year*

Email*

Phone

T-shirt Size (Unisex)*

Health

Height

Weight

Do you have any medical conditions, disabilities or allergies?

Yes
No

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

Do you have any chronic injuries?

Yes
No

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

Fall Availability

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

Select All
Monday, 7:00-9:00p (Lally)
Tuesday, 5:30-7:30p (Hookway)
Wednesday, 5:30-7:30p (Hookway)
Thursday, 7:00-9:00p (Lally)
Friday, 5:00-7:00p (Hookway)

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 match.*

Select All
09/21 @ University at Buffalo
09/28 @ Cornell
10/12 @ Binghamton
10/19 vs Cornell
10/26 vs University at Buffalo
11/15-17 NCR Regional Championship - Location TBD (if qualified)
12/07-08 NCR National Championship - Houston, TX (if qualified)

Rugby Details

Have you played rugby before?*

Yes
No

Number of Years Experience

What Other Sports Have You Played?

Desired 15s Position

Your Best Skill (tackling, passing, footwork, set pieces...)

The Skill You've Always Wanted to Improve

Anything else you want the coaches to know:

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.