Jacksonville Axemen Rugby League

2016 Player Bio and Availability Form

    FULL Name AS ON ID (This is for air travel)

    Preferred Name (What name do you use)

    Date of Birth (Needed for air travel)

    Month Day Year

    Cell Phone #

    Email

    Occupation

    Weight

    Height

    Hometown

    Playing Experience

    Years

    Preferred Position

    Biggest Life Influence

    Name your Racehorse

    Availability

    (Select the games you are available for):

    May 21st / Home / UnionJune 11th / Away / Atlanta RhinosJune 18th / Home / Tampa MayhemJune 25th / Away / Central Florida WarriorsJuly 2nd / Home / USARL South 9s TourneyJuly 9th / Home / Atlanta RhinosJuly 16th / Away / Tampa MayhemJuly 30th / Home / Central Florida WarriorsAugust 6th / TBD / USARL South Playoff SemiAugust 13th / TBD / USARL South ChampionshipAugust 29th / Away / USARL South Championship

    Emergency Contact

    Phone Number

    Relation

    Medical Insurance (include number)

    Medical History

    Current Medications

    Current Supplements

    Have you had a concussion? YesNo

    If Yes how many?

    Past Illnesses

    Past Medical Procedures

    Past Sport Related Injuries

    Past Hospitalizations

    Allergies

    Axemen 2016 Schedule

    DateHome/AwayOpponent
    May 21stHomeUnion
    June 11thAwayAtlanta Rhinos
    June 18thHomeTampa Mayhem
    June 25thAwayCentral Florida Warriors
    July 2ndHomeUSARL South 9s Tourney
    July 9thHomeAtlanta Rhinos
    July 16thAwayTampa Mayhem
    July 30thHomeCentral Florida Warriors
    August 6thTBDUSARL South Playoff Semi
    August 13thTBDUSARL South Championship
    August 29thAwayUSARL South Championship