TEAM REGISTRATION FORM

***Please type of print clearly and complete all sections***

TEAM NAME___________________________________________________SECTION__________________________SEASON_________________
COLOURS________________________________________________________________________________________STATE___________________
TEAM MEMBERS NAME

EMAIL OR RESIDENTIAL ADDRESS

SIGNATURE

DATE OF BIRTH

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Note: In registration of Under 12s and Under 17s, proof of age must be verified by Extract of Birth Certificate or an acceptable Proof of Age document.

COACH:
Mr/Mrs/Ms____________________________________________EMAIL______________________________________________DDA ACCRED. #_______________
ADDRESS______________________________________________________________________________________________TELEPHONE________________________
TEAM CO-ORDINATOR:
Mrs/Ms________________________________________________EMAIL____________________________________________________________________________
ADDRESS_____________________________________________________________________________________________________TELEPHONE_________________
ASSISTANT COACH______________________________________________________ ASSISTANT T/C___________________________________________________
STATE REGISTRAR_____________________________________________DATE / /

DDA REGISTRAR_________________________________________DATE

DDA TEAM REGISTRATION FORM (R1)