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Pathways Program Registration
Please complete our form to join our list of potential players.
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* Indicates required question
Parent/Guardian First Name
*
Your answer
Parent/Guardian Surname
*
Your answer
Email Address
*
Your answer
Mobile (Optional)
Your answer
Player First Name
*
Your answer
Player Surname
*
Your answer
Player Age
*
Your answer
Gender
*
Male
Female
Which location would you like to attend
*
Penrith
Newcastle
What are your son's/daughters Rugby League Goals?
*
Your answer
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