FFSA 2023 Girls Registration Form
Player Details
Players Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
Suburb
State
Postcode
Date of Birth
*
/
Day
/
Month
Year
Date
Gender
*
Female
Team
*
Under 7
Under 9
Under 11
Under 13
Under 15
Under 17
Requires New Playing Strip
*
Yes
No
Medical Conditions
*
Medicare Number
*
Medicare Reference Number
*
Number next to Childs name
Parents Details
Parent or Guardian
*
First Name
Last Name
Mobile:
*
Email
*
example@example.com
Preferred method of contact
*
Email
Text Message
Phone Call
By accepting below you understand that upon registration you are required to pay a $100 deposit. The remaining registration fees are to be paid within the scheduled due dates.
*
Accept
If you're in primary school to year 9 or born in 2008 or later and complete the medicare information you're allowing Elizabeth Grove Soccer Club to claim the Sports Voucher on your behalf reducing your registration fees by $100
Accept
Occasionally we may use your childs image to promote our club or an upcoming event on facebook or some other forms of social media, is this ok?
Yes
No
Submit
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