Senior Domestic Competition
Team Nomination Form - Winter 2024
Team Name:
*
Singlet Colour:
*
Select a Competition:
*
Please Select
Men WEDNESDAY Div 1/2 - Paul Bancroft Centre
Primary Contact Name:
*
First Name
Surname
Primary Contact Email:
*
example@example.com
Primary Contact Mobile Number:
*
Secondary Contact Name:
*
First Name
Surname
Secondary Contact Email:
*
example@example.com
Secondary Contact Mobile Number:
*
Team Nomination Fee
*
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Team Fee
Summer 2024
$
75.00
AUD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: