GCTA - Wests EOI

Expression of Interest Form

Girls Can Tackle Anything Come and Try day
Participants Name

First NameLast Name
Birth Date

MonthDayYear
School
Parent/Guardian Name

First NameLast Name
Contact E-mail Address
example@example.com
Contact Phone Number
Has the player participated in any form of Rugby program before?

YESNO
If YES what type/level of rugby have you participated in

Not Applicable - I chose NOSchool Rugby ProgramsGirls Rugby 7's club, invitational or representativeGirls Rugby 15's club, or representativeMixed Rugby club or representativeOther
AVAILABILITY (select all options that apply)

Come and Try Session 16th February 5:30pmCome and Try Session 23rd February 5:30pmI am not available for either but want to participate in the GCTA programGCTA Week 1 - Mon 2nd March - Venue EastsGCTA Week 2 - Mon 9th March - Venue WestsGCTA Week 3 - Mon 16th March - Venue TBCGCTA Week 4 - Mon 23rd March - Venue Sunnybank
Please list any Additional Comments
Should be Empty:

Expression of Interest Form