EmailMe Form - Hills District Touch Football Registration

Season *

Year *

Team Name *

Contact Name *

First Last

Contact Mobile Phone # - Used to text updates *

### - ### - ####

Contact Email *

Competition *

O/30s teams can have 2 players between 27-29yrs old. for Div 1/2 these 2 players can be any age.
Mixed Teams must have at least 3 females on the field at all times.

Division *

Date Submitted *

DD / MM / YYYY

Players Names

	Name & Year of Birth	Email address
Player 1
Player 2
Player 3
Player 4
Player 5
Player 6
Player 7
Player 8
Player 9
Player 10
Player 11
Player 12
Player 13
Player 14

Payment - Cheques can be Posted to: PO Box 6272 Norwest Baulkham Hills Business Centre, NSW, 2153. Teams paying in full before commencement of round 1 will earn a bonus 3 points to their teamʼs points tally, 2 bonus points before round 2 and 1 bonus point before round 3. Full payment must be received by round 4.

	I will pay $800 rego fee by:
Direct Deposit to Hills District JRLFC&TA Bank Account – BSB 082-135 Account #: 04 958 4107. (Keep print off of payment for proof purposes)
EFTPOS is available at the ground up to round 4 for registration payments.
Cheques to be made payable to HDRLFC&TA.
Cash is accepted but not preferred for audit and security reasons

Waiver - *

	I/We Agree
Hills District Junior Rugby League Football and Touch Association Incorporated do not cover players with accident insurance. You have advised your team's players that they participate at their risk.
I also give permission for the Club to arrange any medical attention that may be required including ambulance transport and I/Players agree to pay all medical costs incurred.

Photos / Video - *

	I/We Agree	I/We Don't Agree
I/Players agree to allow photos of participating players to be used on the club's social media sites or for advertising which may include local papers