2022 Junior & Miniroos (U7 to U17) Expression of Interest

1
Players Name* This field is required.
First Name
Last Name
2
Date of Birth - note format is Day/Month/Year* This field is required.
Date
Day
Month
Year
3
Gender* This field is required.
Male
Female
4
Potential Playing Level
Kangaroos/A Grade (Experienced)
Wallabies/B Grade (Intermediate)
Joeys/C Grade (Beginner)
5
Previous Club played at?* This field is required.
6
Parent/Guardian Name* This field is required.
First Name
Last Name
7
Parent/Guardian Mobile Number* This field is required.
8
Parent/Guardian Email Address* This field is required.
example@example.com
Should be Empty: