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2022 Parramatta Eels U14's North Male Development Squad
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Players Contact Information
Email address and phone number must be your own (if you have one)
First Name
*
Your answer
Surname
*
Your answer
Email Address
*
Your answer
DOB
*
MM
/
DD
/
YYYY
Mobile number
*
Your answer
Home Phone Number
Your answer
House number and Street name
*
Your answer
Suburb
*
Your answer
State
*
Your answer
Postcode
*
Your answer
Junior League Club 2021 (or Last played at)
*
Your answer
Training Shirt Size
*
XS
S
M
L
XL
2XL
3XL
4XL
Training Shorts Size
*
XS
S
M
L
XL
2XL
3XL
4XL
Country of Birth
*
Your answer
Nationality
*
Your answer
If Australian, City and state of birth
Your answer
Aboriginal or Torres Strait Islander
*
Yes
No
Emergency Contact Name
*
Your answer
Emergency Contact Number
*
Your answer
Relationship to Player
*
Your answer
Emergency Contact Email
*
Your answer
Do you have any pre existing Injuries/Illnesses
*
Your answer
Do you have any anticipated leave (holidays) for 2021/2022 in which you may miss out on training or a game day?
*
Your answer
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