Adult Registration Form

The following form is the information required for adults to register with the Foothills Lions Rugby Club.

The information from this registration form is used by the club to update players on important information that players and their teammates need to know. All information provided is confidential and will only be used for club purposes. Please ensure that all information provided is accurate.

Note: For this form to process properly every single field must have information in it.

General Player Information

Given Name

Surname

Date of Birth

Phone Number (please include extension if required)

Alternate Phone Number (please include extension if required)

Email Address (required)

Mailing Address

City

Province

Postal Code

Division you are interested in playing in:

Emergency Information

Alberta Health Card Number

Family Doctor

Emergency Contacts

Primary Contact

Given Name

Surname

Phone Number (please include extension if required)

Alternate Phone Number (please include extension if required)

Relationship to Player

Alternate Contact

Given Name

Surname

Phone Number (please include extension if required)

Alternate Phone Number (please include extension if required)

Relationship to Player

After you’ve clicked submit, click here to return to registration page to process payment.

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