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Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Participants Name*

Emergency Contact Name*

Emergency Contact Phone Number*

Have you played hockey before?*

Are you a Goal Keeper or Field Player?*

Are you a 2024 registered BWHA or Hockey Queensland member?*

Please select the sessions you will be attending

Thursday 11th July

Thursday 18th July

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Thursday 8th August

Thursday 15th August

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Thursday 29th August