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Junior Registration Form - Northern Stars VC
This is the form is for players under the age of 18 as at 31/12/2020 ONLY. If you are over 18 as at 31/12/2020 please use the alternate Senior Membership Form at
https://forms.gle/91GKHJeLFuBURzRY8
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* Indicates required question
First Name
*
Your answer
Surname
*
Your answer
Gender
*
Male
Female
Date of Birth
*
MM
/
DD
/
YYYY
Age (as at 31/12/2020)
*
Your answer
Player's E-mail Address (optional)
Your answer
Does the player have a medical condition / allergies that require medication or any relevant current injuries?
*
If yes, please provide details and action required below
Yes
No
Your answer
Has this member played volleyball at Northern Stars before?
*
If yes, please provide the most recent coach's name/s below.
Yes
No
Your answer
PARENT/GUARDIAN DETAILS
Name of Parent/Guardian
*
Your answer
Primary E-mail Address
*
Your answer
Residential Address
*
Your answer
Suburb
*
Your answer
Postcode
*
Your answer
Mobile Phone No.
*
Your answer
Are these details the same as the player's Emergency Contact Details?
*
If 'No' please fill out questions below
Yes
No
Emergency Contact Name
Your answer
Emergency Contact Relationship
Your answer
Emergency Contact Number
Your answer
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