ACE 5 aside Kindy

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ACE 5 aside Kindy - U11

Registration form for Kindy - U11 5 aside
Please complete this form and then continue to the website shop to pay for you selection.
One form per player please.

Players First Name *

Players Surname *

Players Date of Birth *

YYYY

Parents Name *

Male or Female - player *

Male

Female

Best Contact Email Address *

Best Contact Phone Number *

Emergency contact name and phone number - different to above

2017 Club, Division and Team - eg ACE U10 Goanna *

5 aside Group - self graded. *The club reserves the right to regrade. Please refer to grading chart on website.

Age Group you would like to request to play in for 2017 comp - self graded. *The club reserves the right to regrade. *

Kindy ages 3,4,5

U10

U11

Required

I am an individual player who would like to be placed into a team - you will be contacted via email to arrange allocation into a team

Yes

5 aside team name - If you do not know please answer not known *

Names of other players in your team - if known. Please use one line per player.

5 aside team contact/manager name -If you do not know please answer not known *

5 aside team contact/manager mobile number - If you do not know please answer not known *

5 aside team contact/manager email address - If you do not know please answer not known *

Medical Conditions - write nil known if not applicable *

Please list any medical conditions.

How did you hear about this event *

Website

Friend

Facebook

Poster

Club Email

Submit

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