Expression of Interest Junior Male players

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Keysborough Junior Male

Expression of Interest

KSC - 28-30 Coomoora Rd, Springvale South VIC 3172

keysboroughsoccerclub@gmail.com

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Player Name* This field is required.

First Name

Last Name

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Date of Birth* This field is required.Day/Month/Year

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Parent/Guardian Name* This field is required.

First Name

Last Name

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E-mail?* This field is required.

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Mobile Phone?* This field is required.

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Which club if any have you previously played forType none if they haven't played for another club

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Does you have any allergies, chronic illness, or medical conditions that would limit high level activtiy?* This field is required.

Yes

No

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Please describe

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After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at keysbroughsoccerclub@gmail.com