Brisbane Roar Half Time Hero
Brisbane Roar vs Auckland FC Venue: Suncorp StadiumDate: Friday 30th Oct Kick-Off: 7:00 PM Meeting Time: 6:15 PM
Player Name
*
First Name
Last Name
Age
*
2026 Mudgeeraba Team
*
Parent / Chaperone (Must be over 18)
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Is the parent happy to assist on field on the day?
*
Please Select
Yes
No
Submit
Should be Empty: