2020 MUWFC Registration
Type of MUWFC member *
Required
Given Name *
Your answer
Last Name *
Your answer
Gender
Home Postcode *
Your answer
Work/Study Postcode *
Your answer
Mobile Number *
Your answer
Date of birth (mm/dd/yyyy) *
MM
/
DD
/
YYYY
Email Address *
Your answer
Please indicate one eligibility that best fits your connection to the University of Melbourne *
University of Melbourne Student Number (where applicable)
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Medicare Number *
Your answer
Medical Information (e.g. existing injuries, mental health, or anything you'd like to disclose)
Your answer
Do you currently take any medications? Please provide details.
Your answer
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)
Your answer
Training t-shirt size (see below) *
Captionless Image
Do you need a new game day uniform kit?
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