Bialik Futsal Player Registrations 2022/23

Player name*

First NameLast Name

Parent/Guardian (if player under 18 Years)

First NameLast Name

Phone Number*

Area CodePhone Number

Email*

example@example.com

Player Date of Birth*

Date

School Attending (if under 18)

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

YesNo Please place me in team

Team name / Coach name*

Yes - Please contact meNo

My Products*

Bialik Under 8s (Born 2014/15)

Starts 7th October

$395.00AUD

Bialik Under 10s (Born 2012/2013)

Starts 7th October

$395.00AUD

Bialik Under 12s (Born 2010/2011)

Starts 7th October

$395.00AUD

Bialik Under 14s (Born 2008/2009)

Starts 7th October

$395.00AUD

Bialik Youth (Born 2007/06/05/04/03/02)

Starts 7th October

$395.00AUD

Futsal Balls (Bialik)

Futsal Ball size 3 and 4 available** Price includes Postage (Aust). Goods posted to Address above.

$44.00AUD

Size	Quantity
Size 3 Ball
Size 4 Ball

Total

$0.00AUD

Pay with Credit Card

Bialik Futsal Club - Player Registrations 2022/23