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 *
Your answer
Players Surname *
Your answer
Players Date of Birth *
MM
/
DD
/
YYYY
Parents Name *
Your answer
Male or Female - player *
Best Contact Email Address *
Your answer
Best Contact Phone Number *
Your answer
Emergency contact name and phone number - different to above
Your answer
2017 Club, Division and Team - eg ACE U10 Goanna *
Your answer
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. *
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
5 aside team name - If you do not know please answer not known *
Your answer
Names of other players in your team - if known. Please use one line per player.
Your answer
5 aside team contact/manager name -If you do not know please answer not known *
Your answer
5 aside team contact/manager mobile number - If you do not know please answer not known *
Your answer
5 aside team contact/manager email address - If you do not know please answer not known *
Your answer
Medical Conditions - write nil known if not applicable *
Please list any medical conditions.
Your answer
How did you hear about this event *
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