MINDARIE NETBALL CLUB
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Winter Season - WDNA
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Registration is closed For Bouncers
Bouncer Joondalup
*
Indicates required field
Child Name
*
First
Last
Parent / Guardians
*
Date Of Birth
*
Address
*
Contact Number
*
Email
*
Current School Year
*
School
*
A player can play up one age group without club authorisation. If a player would like to play up two age groups please send a email to Beck at
beck.mindarienetball@gmail.com for club approval.
Teams
*
Option 1
Option 2
Option 3
Please select 3 positions your child would like to play.
Position 1
*
GK
GD
WD
C
WA
GA
GS
UNKNOWN
Position 2
*
GK
GD
WD
C
WA
GA
GS
UNKNOWN
Position 3
*
GK
GD
WD
C
WA
GA
GS
UNKNOWN
Declaration
If under 18 years of age a parent / guardian must sign:
I agree that the registered player on this form and the attending parent/guardian/spectator will abide by the rules and regulation of the Mindarie Netball Club and Bouncers Sport Centre.
I give permission for the registered player on this form to represent the Mindarie Netball Club.
Parent/ Guardian
*
Signature
*
Medical Conditions
Does your child suffer from any Medical Condition?
*
Yes
No
If Yes
*
Does your child take any regular medication ?
*
Yes
No
If Yes
*
Payment
Your payment will be processed in 3-5 business days
Payment Method
*
Visa
Master Card
Name On Card
*
Card Number
*
Expiration Date
*
CCV
*
Payment Amount
*
$220
$160 Winter Refund
Kids Sport Voucher
Submit
Home
Club
Policies
Committee
Sponsorship
Roles
Gallery
Registration
Winter Season - WDNA
Uniforms
About
Contact
