SBSC Players Expression of Interest Form 2025

Southern Breakers Soccer Club

Players Expression of Interest Form - Season 2025
Players Name *

First NameLast Name
Date of Birth*

DayMonthYear
Date
Age*
Team Information

Please choose below
Junior Boys Teams
Junior Girls Teams
Women's Senior Team
Men's Senior Team
Emergency Contact Information (Parent/Guardian)
Name of Emergency Contact*

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

SuburbState

Post Code
Email*
example@example.com
Relation to Player*
I am consenting that the child named above may be photographed IN A GROUPSETTING, for use in our club social media promotions, on our club website, and for general club promotional activities, with no names associated with the photograph.*

YesNo
Parent/Guardian/ Player Name*

First NameLast Name
Date Signed*

DayMonthYear
Date
Hi Players and Parents,

Our club will always be one that puts the utmost importance on inclusiveness and opportunity.

Every child who wants to play will be found a place and this provides a valuable experience for them and their peers.
Should be Empty:

Southern Breakers Soccer Club