Player Name*

Date of Birth*

Gender* Please select... Male Female

What ages will you be playing in BWP competition with Rivercity?*

States primary age - Are you planning on playing for Rivercity in your primary age group at State Titles?* Please select... Yes No

States secondary age - Are you planning on playing up an age group for Rivercity at States Titles?* Please select... Yes No

AYC primary age - Are you planning on playing for Rivercity in your primary age group at AYC?* Please select... Yes No

AYC secondary age - Are you planning on playing up an age group for Rivercity at AYC?* Please select... Yes No

If we do not have enough for a team in your age are you happy to play in a combined team (i.e. if 2 clubs have 6 players each they may merge) Please select... Yes No

What competition do you want to play in for your primary age group?* Please select... No/NA Competitive Development either

Would you prefer if team travelled to AYC as a group with chaperones?* Please select... Unsure/NA Yes will travel as a family

Would you be interested to be a team chaperone/Manager at States/AYC?*

Further information Max. 255 characters