Club to Club Player Release Form

PLAYER RELEASE FORM

Request a release from your existing Club and/or request membership to a new Club. Note: The person submitting this form must be the playing member requesting this action or the parent/guardian of the playing member if under 18 years. No third party can submit this form on behalf of the member.
Today is

DayMonthYear
Date
Existing Club
New Club
Player Profile
Player Name*

First NameLast Name
Gender*
Player Birth Date*

DayMonthYear
Age Group*
Player Address*

Street Address

Suburb

CityState

Postal Code
Highest Level Played in Club?*

Parent/Guardian
Parent/Guardian*

First NameLast Name
E-mail*
Mobile *
Parent / Guardian Authorisation

I agree with this transfer request
I declare I am the player stated as making this application or if under the age of 18 years I am the parent guardian of the player in this application. That all the information I have provided is compete and correct and submit this application in good faith
Player Application

I agree to the above declaration
Should be Empty:

PLAYER RELEASE FORM