Blackburn Newhope FC Registration 2021

Senior Men Registration
Senior Men Registration Type *

Casual (5 Games) Concession (Student with Valid ID) Standard
Registration Cost
Mens Player

First Name Last Name
Birth Date

Day Month Year
Address

Street Address

Street Address Line 2

City State

Postcode
Player Mobile
Email *
example@example.com
Do you need an uniform?

Yes +$40 No
Are you a new player and require a BNFC shirt? If so let us know what size you think you will need.
Do you have any medical conditions BNFC should know about?
If you do please let us know them here. If you have none simply enter 'None'
Under 18? *

Yes No

Senior Ladies Registration
Senior Ladies Registration Type *

Casual (5 Games) Concession (Student with valid ID) Standard
Registration Cost
Ladies Player

First Name Last Name
Birth Date

Day Month Year
Address

Street Address

Street Address Line 2

City State

Postcode
Player Mobile
Email *
example@example.com
Do you need an uniform?

Yes +$40 No
Are you a new player and require a BNFC shirt? If so let us know what size you think you will need.
Do you have any medical conditions BNFC should know about?
If you do please let us know them here. If you have none simply enter 'None'
Under 18? *

Yes No

Family Details
Parent/Guardian 1 *

First Name Last Name
Home Number
Please provide at least one contact number
Mobile Number
Please provide at least one contact number
Address *

Street Address

Street Address Line 2

City State

Postcode
Email *
example@example.com

Parent/Guardian 2
Parent/Guardian 2

First Name Last Name
Home Number
Mobile Number
Address is same as Parent/Guardian 1

Yes No
Address *

Street Address

Street Address Line 2

City State

Postcode
Email
example@example.com

Declaration and Authorisation
I the undersigned, approve of the application(s), and in so doing understand that no form of financial responsibility for any accident or injury is accepted by the Blackburn Newhope Football Club, the Association, Committee members, or other Officials.

I do authorise, in the event of any accident or injury, the provision of such medical assistance that may be required, and agree to meet any expense attached thereto. We advise that your fees do include insurance which can be read about here. This is provided through the VCFA and not BNFC.

I agree to adhere to the club's code of conduct for Parents and Spectators. I agree/on behalf of my child(ren) to adhere to the club's code of conduct for Players and the VCFA Match Rules (link is for 2016 rules). I also agree to pay any fines levied by the association due to misconduct by myself or my child(ren).

I agree to contribute to the running of the Club by responding to requests for support in the various jobs that must be performed at team and club level.

I accept that the Club will not disclose any personal details to any other parties, except the Victorian Churches Football Association Inc. and will only use contact details for distribution to Club officials for communication within the Club.

I agree that the Club and NewHope Baptist Church may use any photograph or video recording at any match, training session or Club event for marketing purposes or their respective websites.

I agree that any cancellation and refunds are at the full discretion of the club committee giving consideration to circumstances. After the start of the first game played there is a non-refundable amount of $100 per player except KickOff whihc is $50 per player. If a player registers and then cancles their registration before playing a game an administration fee of $25 is charged.
Name of the Senior/Parent/Guardian Signing the Declaration: *
Signature *

Clear
Date *

Day Month Year
Date

Payment Options

Please selection a payment option from the selection below. If you select Direct Deposit please ensure you pay before the 1st of February before the prices go up. We calculate the fee in this order Player Rego - Volunteer Discount - Multi Player Discount - Early Bird Discount + Uniform Levy (If required).
Discounts

Early Bird gets you an automatic 10% if registered and paid by the 31st January.

Discount applied to registration total if multiple players are registered:

1 Player = 0%

2 Players = 5%

3+ Players = 10%

*Uniform levy is added after discounts as this has a fixed cost associated to it.

Player Type	2020 Fee
KickOff (Ages 4.5 - 7)	150

U8 - U10 Juniors Player	230

U11 - U18 Juniors Player	280

Senior Casual *	165
Senior Concession (Student with Valid ID)	325
Senior Standard	375

New Player Uniform Levy **	40

* Casual registration allows you to play up to 5 games. If you wish to play more these will cost $100 per block of 5 games. If you want to play the season this will be a more expensive option than a full registration at the start of the season. This represents the added administration work required to administer a casual rego.

** The uniform levy will get you club shorts and shirt. You will need to purchase your own game day socks. From 2019 onwards all players are required to have home and away socks. BNFC use green for home and black socks for away. Both the black and green socks can be purchased from the club for $12 a pair or you can purchase your own. Please check the green colour of our socks first so they match.

Please note that payment must be received before uniforms, balls and players are able to commence playing. A $25 administration fee will apply if you cancel prior to season starting. Any fee refunds after the season starts are at the sole discretion of the club committee. There is a non-refundable amount of $100 after your first game is played.

New players will pay an additional $40 as part of our uniform levy. This entitles each player to shorts and playing shirt.
Where would you like the confirmation email to be sent? *

Parent/Garudian 1 Mens Player Ladies Player Custom - Please enter email below
Confirmation Email
example@example.com
I am a returning Coach or Team Manager or have the secret code:

Yes No
What is the code? *
What team were are you involved with?
Maximum Key Volunteer discount to apply
Player Rego Total Pre Discounts
Player Rego Post Volunteer Discount
Total Number of Players
Multi Player Discount
Player Rego Post Multi Discount
Registration Post Early Bird Discount
Uniform
Registration Total Cost
Registration Cost Summary:

KickOff SubTotal: ${kickoffRegistration}

U8 - U10 SubTotal: ${juniorU8u9333}

U11 - U18SubTotal: ${juniorRegistration}

Ladies SubTotal: ${registrationCost317}

Mens SubTotal: ${registrationCost}

Rego Fees Total: ${playerRego}

Rego Fees After applied discounts: ${registrationPost491}

Uniform Fees: ${uniform}

Total: ${registrationTotal}
Payment Options *

Debit/Credit Card (At BNFC and NHBC we use Stripe to process online Credit Card payments) Direct Deposit / Bank Transfer
Direct Deposit / Bank Transfer:

Once you submit this form you will be sent the details for payment automatically. Please ensure this is paid as soon as possible and within the guidlines at the start of this form.

Payment in full is required before the season starts. Any players that are non-financial will not be eligible to play. If you need to organise a payment plan then please register, select Direct Debit and contact us as soon as possible. A $25 administration fee will apply if you cancel prior to season starting. Once the season has started there is a non-refundable amount of $100 per player ($50 per KickOff player). Any refund beyond this are considered by the management team on a case by case basis.

Registration Total *

AUD Registration Total

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Sumbit

When you press submit it will take a few moments to process anything and then show the confirmation page. Please ensure you keep this page open until the confirmation page shows. If you have waited for more than 5 minutes please close this window and check with us if your registration was successful or not.
Should be Empty:

BNFC 2021 Player Registration

Privacy

Discounts

KickOff

Juniors

Seniors

Payment

Senior Men Registration

Senior Ladies Registration

Family Details

KickOff Player Details

Medical Information

School Details

Medical Information

School Details

Medical Information

School Details

U8 - U10 Junior Player Details + U12 Girls

Medical Information

School Details

Medical Information

School Details

Medical Information

School Details

U11-U17 Junior Player Details

Medical Information

School Details

Medical Information

School Details

Medical Information

School Details

Medical Information

School Details

Other Information

Request for volunteers

Declaration and Authorisation

Payment Options

Discounts

Sumbit

Player Type	2021 Fee
KickOff (Ages 4.5 - 7)	150

U8 - U10 Juniors Player + U12 Girls	230

U11 - U18 Juniors Player	280

Senior Casual *	165
Senior Concession (Student with Valid ID)	325
Senior Standard	375

New Player Uniform Levy **	40