Portsmouth Pirates Membership 2021
Please fill in all questions accurately. Membership for the 2021 is £35 this includes your after game polo. Match fees are payable separately at £10 a game (18 a side) £5 a game (9 a side). Please pay your membership fees at your earliest convivence and send an email to Jake Moller club treasurer to confirm payment.

Legal First Name *
Legal Family Name *
Date of Birth *
Gender *
Email Address *
Country of Birth *
Passport Nationality *
AFL Team Supported
Polo Shirt Size *
Portsmouth Pirates will only share your details for the purpose of player registration. We shall not share your details with any other party unless permission has been sought and confirmed. Please check the box to confirm you have read and understood. *
I understand that Australian Rules Football is a contact sport and there is an element of risk attached to taking part. In taking part in any session organised by Portsmouth Pirates ARFC, I accept all liability for any injury sustained as a result. Please select the box below to state you agree to the above statement *
Portsmouth Pirates plan to take photos and videos during sessions. Do you give your consent for Portsmouth Pirates ARFC taking and using your image for social media and website advertising? *
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