PBFC MiniRoos and Juniors Registration Form 2018
*FEE STRUCTURE: BELOW
*PAYMENT OPTIONS: Direct Deposit to Pagewood Botany Football Club Inc - BSB 032-056, Account Number 469031
In 2018, paying by card in person will incur a 1.9% surcharge, we recommend paying by Direct Deposit above.

REGISTERING BEFORE 31st JANUARY:
1. If you register before 31st January and wish to use the Active Kids Voucher, we will keep your registration pending and will require your voucher at the in person registration days February 3rd/4th.
2. If you register before 31st January and do not wish to use the Active Kids Voucher, we can process your registration on payment of the "without Active Kids Voucher" fee. We recommend you use the Direct Deposit option below to make things quick and easy.

REGISTERING AFTER 31st JANUARY:
1. If you wish to use the Active Kids voucher through PBFC, please make sure you are registered through Service NSW Online and claim your voucher and input code below.
2. If you do not wish to use the Active Kids Voucher with PBFC, we can process your registration on payment of the "without Active Kids Voucher" fee. We recommend you use the Direct Deposit option below to make things quick and easy.
3. If you wish to pay by card in person and need help with filling in your registration please come down to the in person registrations

IN PERSON REGISTRATION AND HELP:
Where - Club Hillsdale - 49 Rhodes Street, Hillsdale
Saturday 3rd February - 11am to 3pm
Sunday 4th February - 10am to 2pm

Email address *
2018 FEE STRUCTURE
Club Status
Team in 2017
Your answer
FFA Number of Player Registering (if you do not know it, do not worry)
Your answer
Player NSW Government Active Kids Voucher - $100 discount (https://sport.nsw.gov.au/sectordevelopment/activekids)
Your answer
Player First Name (as will be printed on Trophy) *
Your answer
Player Last Name (as will be printed on Trophy) *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Player Email (if child does not have an email address please leave this blank)
Your answer
Player Mobile (if child does not have a mobile phone please leave this blank)
Your answer
School *
Your answer
Address (# and Street) *
Your answer
Suburb *
Your answer
State *
Your answer
Postcode *
Your answer
Parent 1 Name *
Your answer
Parent 1 Email *
Your answer
Parent 1 Mobile *
Your answer
Parent 1 Street Address *
Your answer
Parent 1 Suburb *
Your answer
Parent 1 Postcode *
Your answer
Parent 1 Occupation
Your answer
Parent 1 Willing to volunteer / help out the club *
Parent 2 Name
Your answer
Parent 2 Email
Your answer
Parent 2 Mobile
Your answer
Parent 2 Street Address
Your answer
Parent 2 Suburb
Your answer
Parent 2 Postcode
Your answer
Parent 2 Occupation
Your answer
Parent 2 Willing to volunteer / help out the club
Payment *
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