BWHA - 2024 U11 Off Season Development Registration

Details

Tue 12 Nov 2024 17:00 — Tue 26 Nov 2024 19:00
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Brisbane Women's Hockey Association, 16 Melbourne Street, Windsor QLD 4030

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First name*

Last name*

Phone number*

Email address*

Address*

Players First Name*

Players Surname*

Date of Birth*

Mobile Number*

Primary Email Address*

Do you require all correspondence to be sent to a second email address?*

Second email address

Parent/Guardian Name 1 (18+ type N/A)*

Parent/Guardian Name 2

Club*

What Division you are registered in? (this is your primary team that you play your most hockey with)*

Preferred session time*

4:50pm - 6:00pm

5:50pm - 7:00pm

Preferred Playing Position*

Do you have any current injuries/medical concerns? Max. 255 characters

Are you unavailable for any clinic dates?

Is there anything else you would like us to know? Max. 255 characters

Please note

Please note to complete your registration, clinic payment must be paid on submission.

You must be a Primary Registered BWHA Member to participate in our Development Programs.

I confirm that I have read the above Terms Of Registration in its entirety.*

I agree to the Terms Of Registration.*

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*