Registration for all Junior Competition Teams

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Please register your child's details as a player for the Junior Competition - please note this form is ONLY for players for competition grades and only for players from school years 3.4.5.6.7 & 8 - we will register NON PLAYING juniors next month for the skills program.

Did you play for Rangiora last season? *

Yes

If YES - please state which team or coach your child was in

What school do they attend? *

Please make sure you tick the correct box for the grade based on the players SCHOOL YEAR *

MINI Sticks - school year 3&4

KIWI Sticks - school year 5&6

KWIK Sticks - school year 7&8 - it is anticipated that we will ONLY enter 11 a side teams

Required

Player school year *

Yr 3

Yr 4

Yr 5

Yr 6

Yr 7

Yr 8

Required

Player's Name *

Players Gender *

Female

Male

Player's Date of Birth *

YYYY

Address *

Please enter your full address including postcode

Email address *

Mobile phone number *

Please provide a mobile phone number as your primary contact - this will be used for team texts etc

Emergency Contact details - Name

Emergency Contact details - email address *

Emergency Contact details - Phone number (preferably a mobile please) *

Are there any special requests we should be aware of? We will do our best to accommodate any requests to be in specific teams etc, but can not guarantee that we will be able to make this work for every case. *

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