Bayside Argonauts Football Club » Registration Form

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Registration Form

SECTION 1: Player Details

Player 1 (required)*

Surname*
Firstname*
Concession Card Number
Gender*	Male Female
Date of Birth*
Age group
Passport or Birth Certificate Number
Medical conditions (if any)

Player 2

Surname
Firstname
Concession Card Number
Gender	Male Female
Date of Birth
Age group
Passport or Birth Certificate Number
Medical conditions

Player 3

Surname
Firstname
Concession Card Number
Gender	Male Female
Date of Birth
Age group
Passport or Birth Certificate Number
Medical conditions

Player 4

Surname
Firstname
Concession Card Number
Gender	Male Female
Date of Birth
Age group
Passport or Birth Certificate Number
Medical conditions

Player 5

Surname
Firstname
Concession Card Number
Gender	Male Female
Date of Birth
Age group
Passport or Birth Certificate Number
Medical conditions

SECTION 2: Guardian Details

Parent 1/ Guardian 1 - Primary Contact

Surname*
First/Preferred Name*
Mobile Phone Number*
Email*

Parent 2 / Guardian 2

Surname
First/Preferred Name
Mobile Phone Number
Email

Address Details

Home Street Address*
Suburb*
Postcode*
Home Phone Number*

SECTION 3: Registration Fees

Please select number of players for each age group:

U6/U8 SSG
U9/U10
U11/U14
U15+

SECTION 4: Payment Details

Payment Options*
Date of Payment*

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