Coaching Registration - Wales Rugby League

First Names *

Surname *

Date of Birth (please put the correct year in. Do not leave at this year!) *

Birthplace *

Street Address *

Apartment, suite, etc

City

County

Current home Postcode

Gender *

Gender assigned at birth *

Email Address (parents or guardian's if aged 17 or under) *

Phone Number (parents or guardian's if aged 17 or under) *

Team Registering for *

Last year's club and age group (if applicable) *

Profile picture *

No file chosen

Please upload a profile picture of yourself, preferably in the shirt or leisurewear of your registered club. It is preferred that the name of the file uploaded is the name of the player and club.

DBS Number *must be RFL or WRL DBS check. Please email stephen.jones@walesrugbyleague.co.uk if you have queries

Date of DBS certificate *

Name of School (if at school)

Parent / Guardian name (if you are under 18)

Relationship (e.g. mother, father etc)

I consent to receiving marketing communication from Wales Rugby League, including promotional offers and ticketing information.Yes