Name of Participant:
*
Name of Parent:
Age:
*
Gender: Female Participants Only
Any Medical Illness?
*
No
Yes
If yes, please state the illness:
Email:
Telephone Number:
*
Event Group :
*
Select an option:
8yrs - 11yrs
12yrs -15yrs
Payment
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Bank Transfer
Cash (Pay at the Door)
Comment
By submitting this form, you agree to indemnify and to hold harmless Footy Promotions, its members, coaches, officers or designates from any kind of claim whatsoever.
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