Membership Form (copy
and paste)
Please use BLOCK LETTERS and answer all questions
Please also not any medical condition which may affect your play
Name:
Sex:
Address:
Ph/Fax/Mobile:
Email address:
Occupation/School:
Club name:
Category:
(please circle applicable boxes)
|
U12
Wed
nights |
U15
wed
nights |
Snrs
Tue
nights |
State
League team |
Aus
titles
April
6+7 in Melbourne |
Otherplease
specify |
|
Player |
Scorer |
$
collector |
Coach |
Referee |
Volunteer |
Signature (of player or parent/guardian) agree
to pay full fees:
|
|
day |
mth |
2002 |
|
|
Date
received |
Amt
AFA fees |
Match
fees |
Receipt
# |
initial |
|
|
/
/2002 |
|
|
|
|
