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Parklands Netball Club Inc.c/- Darebin YMCA
857 Plenty Road, Reservoir [email protected]
www.parklandsnetball.com.au
Please return form with $100 deposit in person by 25th November 2016
Player Name:____________________________________________________Date of Birth:_______________________
Address: _________________________________________________________________________________________________________
Suburb: _______________________________________________________________________ Postcode: ________________________
Home Phone: __________________________________ Mobile: ________________________________________________
Parent/Guardian Email Address:______________________________________________________________________________(This is used for invoices and general correspondence – please check regularly.)
Parent/Guardian 1 Name: ___________________________________________ Mobile: ______________________________
Parent/Guardian 2 Name: ___________________________________________ Mobile: ______________________________
Did you play with Parklands in Season 2 2016? Yes / No What Team did you play with __________________________?
Please indicate your preferred playing positions below:
(1) ___________ (2) ___________ (3) ___________
GS – GA – WA – C – WD – GD – GK
U9 & U11 Only: If possible, I would like to play with the
following friends. Please include friend’s full name
(1)_______________________________________
(2)_______________________________________
** The Club may use photographs and other images of players on our website and social media. If you object to this please notify the President. Otherwise registration is deemed to have the consent of the parent or guardian.
Comments or Feedback:
Please enclose a non-refundable deposit (or copy of online bank transfer receipt) to secure your position. Balance of fees due by 24th February 2017
Deposit is $100Office Use OnlyItem Fee Total
FeesNet Set Go U-9 $130Standard Fee $185Uniform - $60 Dress / $45 Singlet $60VNA Registration $50Sibling Discount -$10Total
Office Use Only Receipt Number: Payment Amount Cash / Cheque
Direct Deposit Date:
Please make EFT payments to: BSB 033-028 A/C 291541 Reference: Players surname and Deposit.
If unable to attend registration night, please scan and email this form to [email protected]
Registration Form S1 2017
