Pirates Juniors Registration 2018-19
Early Bird Registrations close: Sunday 5th August 2018 Midnight
Registration Address: Corbin Reserve Pye road Quakers Hill
Contact us at qhpirates@gmail.com
Player Name *
Your answer
DOB *
MM
/
DD
/
YYYY
Parents Name *
Your answer
Parents Email *
Your answer
Parents Mobile Number *
Your answer
Address *
Your answer
Medicare No: *
Your answer
New Player Yes or No *
Comments
Your answer
Medical History / Allergies
Your answer
I will be using the Active Kids Voucher as part of my Registration *
Active Kids Voucher Contact
Please Email Lisa - treasurer@qhpirates.com.au your voucher for confirmation of Rebate.
Please tick the boxes where you think you can help Pirates Baseball *
Required
Pirates Club Fees
I understand that I will have to pay Pirates Club Fees as well as State and National Capitation Fees. Pirates Bank Details bsb# 032071 account# 763220 *
Required
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