2024 Indoor Representative Player - Expression of Interest

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Details

Wed 17 Jul 2024 00:00 — Mon 29 Jul 2024 23:59

Taree Hockey Centre, Recreation Drive Taree

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First name*

Last name*

Phone number*

Email address*

Address*

Date of Birth*

Please specify the Age Group that you are eligible to participate in.*

Gender*

Male

Female

Please note

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