2021 MUWFC Registration
Type of MUWFC member *
Required
Given Name *
Last Name *
Gender *
Home Postcode *
Work/Study Postcode *
Mobile Number *
Date of Birth (dd/mm/yyyy) *
MM
/
DD
/
YYYY
Email Address *
Please select ALL eligibility that best fits your connection to the University of Melbourne (UoM) *
Required
University of Melbourne Student Number (where applicable)
If you registered with a football club prior to joining MUWFC (in either 2020 or 2019), please list the full name of the club
If you have been training with or are signed up to a VFLW club for the 2021 season, please list the club below
Emergency Contact Name *
Emergency Contact Number *
Medicare Number *
Medical Information (e.g. existing injuries, mental health, or anything you'd like to disclose)
Do you currently take any medications? Please provide details.
Do you have private health insurance? *
Do you have ambulance cover? Please note that should you require an ambulance at any stage, one will be called regardless of whether you have ambulance cover (memberships can be purchased online at https://www.ambulance.vic.gov.au/membership/) *
Ambulance Membership number (if applicable)
Do you have a current Working With Children Check? *
Please enter your WWCC number and expiry
Training t-shirt size (see below) *
Captionless Image
Would you like a nickname or surname added to the back of your training tee? If so, please list below. If this is left blank, it will be assumed you do not want a name printed on the back.
Do you need a new game day uniform kit? (this information will be passed onto our Merch team to help kit you out!) *
What is your preferred jumper number? You can state a few but priority will be given based on a player's affiliation with the club. State your existing number if you choose to keep it.
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy