Glebe District Hockey Club Membership Application Form
What is your First name *
Your answer
What is your Last Name *
Your answer
What is your postal address *
Your answer
What is your mobile number *
Your answer
What is your email address *
Your answer
What is your date of birth *
Your answer
Please provide an emergency contact *
Include in your answer a (Name: + Mobile Number: + Relationship to player:)
Your answer
Preferred Playing positions *
Please provide at least three preferred playing positions
Your answer
Which section of the Glebe District Hockey Club are you seeking to join? *
Note: you can choose more than one section if you plan on playing both juniors and seniors
Required
Please indicate if you are joining the Glebe District Hockey Club from another Club in Sydney, NSW or other states or territories *
Required
Please indicate if you are interested in: *
Required
Special Requests *
(e.g. same team as any other players)
Your answer
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