160 Hughes Dr. • Traverse City, MI  49686 • Phone: 933-8229 • Website: www.tbays.org
RUGBY Registration
Sponsored by 


PLAYER INFORMATION

Player’s Last Name 	Player’s First Name 
Date Of Birth  	Sex  Male  Female
Address  City    Zip 
email address: 

PARENT/GUARDIAN INFORMATION
(Employment Info Requested For Alternate & Emergency Contact Purposes)

Mother’s Name    Home Phone 
Mother’s Place Of Work   Work Phone 
Father’s Name    Home Phone 
Father’s Place Of Work   Work Phone 

	

	

	

		
Please mail a completed Medical Release to 
	160 Hughes Dr., Traverse City MI 49686 

	

	
as soon as possible.  

	

	



	

	Fees & Payment

	

	 $100/Player – T-Shirt Included with fee

	
 

	

		T-Shirt Size (Adult Sizes):  

	

	 

	
 

	

Please fill out the credit card information below.  Online registrations MUST include payment information.

	


 VISA or  MASTERCARD    Exp. Dat