Player Details *

First Name

Last Name

DOB *

Date of birth

MM

DD

YYYY

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you wish to be identified as indigenous? *

Yes

No

Age/Division *

Please select the age/grade you will be trialling for

U11

U13

U15

U17

U21

Grade (Womens)

Premier League

19 (TNL)

OPENS (TNL)

Preferred playing positions 1 *

Please select your first preferred playing position

GK

GD

WD

C

WA

GA

GS

Preferred playing positions 2 *

Please select your second preferred playing position

GK

GD

WD

C

WA

GA

GS

Parent Name

First Name

Last Name

Do you suffer from any of the following conditions? *

Epilepsy

Heart Condition(murmur etc)

Allergies(insects,medication etc)

Ear disorders(drainage tubes, deafness etc)

Fainting/Dizzy spells

Diabetes

Respiratory disorder (asthma etc)

Are you currently taking any medication?

None of these above

I have transferred my $70 non-refundable deposit to the bank account *

Please note - you cannot participate or be considered for a team without paying a non-refundable $70 deposit. Bank Details for transfer: BSB 633-000 Account No. 163 856 479 Enter the player name as the reference e.g JSMITHDEPOSIT

Yes (Please provide receipt/transfer details in the text box below)

No (I will bring cash to selections)

Acknowledge fees payment *

I acknowledge that I am required to pay a $70 deposit to be considered for a team and that all registration fees and uniform purchases will be paid in full by Round 1. Failure to do so may result in me being unable to take the court

Yes

Authorise medical treatment *

I authorise the club to obtain any medical assistance deemed necessary during club activities and I will pay all medical expenses incurred. I understand that such assistance may be obtained from the nearest GP, medical centre or hospital

Yes

Consent to use photos *

I consent to allow the use of my/my child's name or photo in club publications such as newsletters, websites Facebook, promotional materials or email

Yes

No