2018/2019 Post Xmas Summer Competition Junior Registration Form 2018/2019 Post Xmas Summer Competition Junior Registration Form Team Name*Shirt Colour*Team will participate in the following competition*Post Xmas Summer Hockey Competition running from Monday 7th January 2019 to Friday 1st March 2019Division 1 - School Year 5 to School Year 8 in 2018Division 2 - School Year 9 to School Year 12 in 2018School Year in 2018*Please confirm school year the kids were enrolled in for 2018 (multiple options) Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Year 12 Where do the kids go to school?School NameContact Details of Team Captain/Team Manager/Team CoordinatorName* First Name Surname Address* Street Address Suburb State Post Code Home PhoneMobile Phone*Email*Please enter these details carefully as this is the address that your confirmation email and invoice will be sent to. EMERGENCY CONTACT DETAILS*This is the person we need to contact in a medical emergency. Yes (click here if details are as above) No (click no and enter emergency contact details below) Name First Name Surname Home PhoneWork PhoneMobile PhonePhoto Permission (check one box)* I grant permission to have my team member's photo's published in any club based media I do not wish to have my team member's photo's published in any club based media CommentsAny comments? Fill in belowTeam Nomination Fees*Team nomination fees are due by no later than Friday 18th January 2019.Bank details are as follows:Southern River Hockey Club IncBSB - 633-000 A/C - 162907174Reference - Team Name Juniors (Div 1)Juniors (Div 2)Total $ 0.00 PhoneThis field is for validation purposes and should be left unchanged.
