Name

First NameLast Name

Date of Birth

dd/mm/yyyy

Address

Street Address/PO BOX

Street Address Line 2

CityState

Zip Code

Phone Number

Please enter a valid phone number.Format: 0000000000.

Email

example@example.com

Playing Position (select top 3)

Would you be interested in playing for the 2026 Winter Competition?

Do you grant permission to be photographed or filmed during the games for promotional and club-related purposes?

PAYMENT

Payment must be paid in full either in cash or via Electronic Funds Transfer to the below account

Account Name: Toodyay Netball Club

BSB: 633000

Account Number: 112630215

Amount: $45

Reference: Surname of participant

Disclaimer

By submitting this registration form, I acknowledge and agree to the following:

I understand that while all reasonable precautions will be taken to ensure the safety and wellbeing of participants, Toodyay Netball Club, its volunteers, coaches, and representatives will not be held liable for any injury, loss, or damage that may occur during social netball.

I confirm that I am physically fit to participate in basic physical activity.

In the event of injury or illness, I authorise Toodyay Netball Club representatives to seek appropriate medical assistance for myself if I am unable to do so, and I agree to bear any associated costs.

By signing below, I confirm that I have read and understood this disclaimer.

Signature

Date