Senior Registration Form - Northern Stars VC
This Registration Form is for players at or over the age of 18 as at 31/12/20 ONLY. If you are under 18 as at 31/12/20 please use the alternate Junior Membership Form at https://forms.gle/Cw7fo8nFgm87aY45A
First Name *
Your answer
Surname *
Your answer
Gender *
Date of Birth *
MM
/
DD
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YYYY
Age (as at 31/12/20) *
Your answer
Email Address *
Your answer
Do you have a medical condition/allergies that require medication or any relevant current injuries? *
If yes, please provide details and action required below
Your answer
Residential Address *
Your answer
Suburb *
Your answer
Postcode *
Your answer
Mobile Phone No. *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Relationship *
Your answer
Emergency Contact Number *
Your answer
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