Van Diemen Fencing Club Registration 2019
Hello!

Please complete this form to register as a member of Van Diemen Fencing Club for 2019.

Thank you!

Coach Avery
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Email *
Member's full name *
Preferred name
Pronouns
Member's email address (or parent/guardian's) *
Member's mobile number (or parent/guardian's) *
Emergency contact name/s *
Emergency contact number/s (if different to the above number/s) *
Emergency contact relationship/s to the member
D.O.B. dd/mm/yyyy
Please provide details of any medical issues, injuries etc we need to be aware of:
Lefty or Righty?
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School grade (if applicable)
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How did you find out about the club? *
Please select your VDFC location/s
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Please tick each of the following to show that you understand the safety conditions: *
Required
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