Coaching application form

WP Rugby Coaching
Please register below.
Your Name *

First Name Last Name
Your cell no *
H/W Contact no *
Your email *
RSA ID no *
League or Region
Super League A *
Super League B *
Super League C *
City League *
Northern League *
Southern League *
Paarl Region *
Simonsberg Region *
Metro League *
Please choose the course you would like to do
Please choose the Level 1 Fifteens date you would like to attend
Please choose the Level 2 Fifteens date you would like to attend
Please choose the Level 1 S&C date you would like to attend
Please choose the Level 2 S&C date you would like to attend
Please choose the Level 1 Sevens date you would like to attend
Please choose the Level 2 Sevens date you would like to attend
Level 1, 7’s, S&C coaching R300
Level 2 coaching R500
Level 1 coaching R300
Course fee
Fee
Address
Postal Code
Please specify your main rugby commitment

Mini-Rugby Junior u12-u18 Youth u17-u19 Senior Women’s Rugby
Boksmart certified

Yes No
Boksmart Number
Highest academic achievement

School University/College
Current coaching commitments
Coaching history & other rugby achievements
Playing history & positions
I the undersigned fill in your name acknowledge and confirm
1.That I shall be attending the course at my own risk and
2.That the WPRFU shall not be liable for any claim, irrespective of the nature, and/or any other damages, which I may suffer as a result of or incidental to my attaendance at the said course.
Signed at location on this Date
Signature

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Club
World Rugby Level 1
- Beginners guide to rugby
- Rugby ready
- Concussion general
- Introduction to coaching
- Coaching key factors
You can sign up for this course at https://passport.world.rugby

Please also complete the COVID Awareness certificate by clicking this link
World Rugby Level 2
- Rugby ready
- Laws online module
- Concussion public online module
- Key factor analysis
- Functional roles
- Introduction to coaching
- Conditioning for Rugby pre-level 1
You can sign up for this course at https://passport.world.rugby/

Please also complete the COVID Awareness certificate by clicking this link
World Rugby Seven coaching
- Rugby ready
- Laws of the game
- Concussion public online module
- First Aid
- Functional roles
You can sign up for this course at https://passport.worldrugby.org/

Please also complete the COVID Awareness certificate by clicking this link
Sevens Pre-requisites
World Rugby Sevens coaching pre-requisites:
1. Rugby ready 2. Laws of the game 3. Concussion public online module. 4. First Aid. 5. Functional roles
Fifteens level 1 Pre-requisites
World Rugby Level 1: Pre-requisites: 1. Beginners guide to rugby. 2. Rugby ready. 3. Concussion general. 4. Introduction to coaching. 5. Coaching key factors
Fifteens level 2 Pre-requisites
World Rugby Level 2. Pre-requisites: 1. Rugby ready. 2. Laws online module. 3. Concussion public online module. 4. Key factor analysis. 5. Functional roles. 6.Introduction to coaching. 7. Conditioning for Rugby pre-level 1
S&C Pre-requisites
Strength & Conditioning Pr-requisites:
Pre-L1 Conditioning for rugby – youth
Concussion general
Final pre-requisites
Should be Empty: