Name *
Surname
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Date of Birth *
School or College
Current school grade
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Preferred Position Tight Head PropHookerLoose Head PropLockFlankEighth ManScrum HalfFly HalfInside CentreOutside CentreWingFullback
Alternate Position Tight Head PropHookerLoose Head PropLockFlankEighth ManScrum HalfFly HalfInside CentreOutside CentreWingFullback
Teams represented grade 10 onwards (school, province, other)
Rugby achievements / awards
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