Canberra United CUBS Miniroos EOI
Fill out this form to express your interest in becoming a Canberra United CUBS for the 2023/24 season.
Parent/ Guardian
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Participants Name
*
First Name
Last Name
Date of Brith
*
-
Month
-
Day
Year
Date
Any Medical Conditions
*
Submit
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