Registration for 2010 Carolina Youth Rugby Festival 

Mail to Carolina Youth Rugby, PO Box 12585 Charlotte, NC  28220

Club ___________________________________________________________

City_________________________________ State or Province______________

Contact Name______________________________ Phone _________________

E-Mail ___________________________________________________________

U-19 men’s sides       ______     X              $200 = ____________

U-17 men's sides       ______     X              $200=_____________

                  U-19 women’s sides  ______     X              $200= ____________                   

U-15 men’s sides       ______     X              $150=_____________

 Total                                                                             ____________­­­­­­­____