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Team Registration/Nomination
Print and fax/mail this form
Please fill out all details. For any section which is not applicalbe please enter NA
Team Information
Name
Home ground address
Colours
Home
Away
Contact Details
First Contact
Second Contact
(Compulsory)
Name
Name
Address
Address
Phone home
Phone home
Phone work
Phone work
Mobile
Mobile
Email
*Any team member
Other Information
Does your team share ground facilities? If yes please supply details of other teams
Prefered Division