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First Name

Last Name

Nickname

Male Female

Student ID

Phone

Address

Email

Height

Weight

40 yard dash time

100 yard dash time

Medical history that should be known?

Asthma, diabetes, heart conditions, nech/head issues, ect...

High School Name

High School city and state

What sports did you play in HS?

Any sporting awards in HS?

Most known coach in HS was?

Father Name

Occupation

Mother Name

Occupation

Parent Phone

Parent Address

College Status

Freshman Sophomore Junior Senior

Estimated Graduation

Major

Minor

Your first semester of WSC Rugby was?

Do you have a campus meal plan?

0 - meal plan 5 - meal plan 10 - meal plan 15 - meal plan 21 - meal plan

Insurance?

Yes No