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KHAOS Elite Rugby Clinic – Rome

Registration Form

15 – 17 June 2026 (Boys U12 – U20)

18 – 19 June 2026 (Girls U14 – U20)

  • Rugby Roma Olympic Club, Via di Tor Pagnotta, 351, 00143 Roma RM, Italy
  • 9:30AM - 16:00PM each day
1
Participant Details
2
Parent / Guardian Details
3
Payment
Participant Information
Full Name *
Age *
Current Rugby Club *
Primary Position *
Playing Experience (years) *
Date of Birth *
Gender *
T-Shirt Size *
Dietary Requirements *
Allergies *
Medical Conditions *
Current Injuries or Recent Surgeries *
Medication Currently Taken *
Parent / Guardian Information
Parent / Guardian Full Name *
Mobile Number *
Email Address *
Relationship to Player *
Secondary Emergency Contact Number
Home Address *
Emergency Contact
If different from parent / guardian
Emergency Contact Name
Relationship to Player
Contact Number
Please make your payment
Pay now via Wise - 1 Day
Pay now via Wise - 2 Days
Pay now via Wise - 3 Days
Payment Confirmation *
Which day/s will you be attending?