Student Registration Form Registration FormPersonal DetailsFirst NameLast NameSurnameGender- Select -MaleFemaleDate of BirthNIC NumberContact DetailsPhone (Mobile)Phone (Home)AddressEmailParent/Primary Care ProviderNamePhoneRelationship- Select -FatherMotherOtherWhat is your relationship with applicant ?EmailOther DetailsHave you played rugby :- Select -YesNoSchoolAge GroupPositionMedical InformationDoes your Child Suffer fromDiabetes Yes NoEpilepsy Yes NoBronchitis Yes NoAsthma Yes NoAllergies Yes NoI the undersigned, hereby declare that the above information is true and correct and agree to abide by the code of conduct enforced by the Academy from time to time.I the undersigned, hereby declare that the above information is true and correct and agree to abide by the code of conduct enforced by the Academy from time to time. I Agree.Submit Form
