Summer Comp - School Super 6's - Yrs 3/4
Nomination Fees to be paid in advance to TBHA $20. Use your surname as reference. BSB: 082 738 Account No. 69 812 9497
First Name *
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Last Name *
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Date of Birth *
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School *
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Year Level at School *
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Team Name (if you have one otherwise you will be placed in a team)
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Team Contact Name
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Email Address *
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Mobile Phone Number *
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Emergency Contact *
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Emergency Contact Mobile Number *
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Hockey Club
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Preferred Position 1
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Preferred Position 2
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