CASH PAYMENT Text First Name* Last Name* Occupation Phone* Secondary Phone Number* Email* Secondary Email Address* Number & Street Address Suburb Postcode Child 1 Name*FirstLast Child 1 - Date of Birth*01020304050607080910111213141516171819202122232425262728293031day / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecembermonth / 20222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901year Child 2 NameFirstLast Child 2 - Date of Birth01020304050607080910111213141516171819202122232425262728293031day / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecembermonth / 20222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901year Child 3 NameFirstLast Child 3 - Date of Birth01020304050607080910111213141516171819202122232425262728293031day / JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecembermonth / 20222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901yearAcknowledgments I will abide by our Code of Conductas published on this website.I acknowledge that junior football is run by volunteers and that I will be required to participate in suitable match duties required by the EDFL to facilitate junior football matches, as requested by the team manager.I acknowledge and give authorisation for my child’s name and photograph being used in Club publications.I acknowledge all jumpers be returned on the final game of season, unless previously purchased.REGISTRATION OPTIONS (PER CHILD)$180 - Under 8s$290 - Bronze$350 - Silver - Includes: Personalised Training Top$30 Canteen Voucher$400 - Gold - Includes: Personalised Training Top$30 Canteen Voucher$50 Bar VoucherClub Back Pack Payment Via Cash$180 - Under 8sQuantity Payment $290$290 - BronzeQuantity Payment 350$350 - SilverQuantity Payment 400$400 - GoldQuantity TOTALBANK TRANSFERThis must be done from your personal bank account and not through this form.Bendigo BankBSB: 633 000ACC: 146818109Hadfield Football ClubSend a copy of this message to yourselfSubmit formReset
