ENC Registration Form 17/18
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
DOB
*
Phone
*
E-mail
*
Emergency Contact Name
Emergency Contact Phone
Emergency Contact Relation
How did you hear about us?
Returning member
Friend
Facebook
Search Engine
Other
A little bit about your netball background
First position preference
GK
GD
WD
C
WA
GA
GS
Second position preference
GK
GD
WD
C
WA
GA
GS
What team/s are you trialling for?
Onyx (1st team - div 1)
Royals (2nd team - div 1))
Scarlets (3rd team - div 2)
Oceans (4th team - div 2)
Any
Please tick all dates you can attend
Tuesday 15th August 8:30-10pm (Taster Session)
Sunday 20th August 1-4pm (First Trials)
Tuesday 22nd August 8:30-10pm (Second Trials)
Are you an umpire? (Please select what grade or none)
A
B
C
None
Are you a coach?
Yes
No
I would be interested in coaching
Would you be interested in becoming an umpire?
Yes
No
Medical (Any medical conditions we should know about e.g asthma)
Are you a student or an adult?
Student
Adult
Any other comments
Submit
Should be Empty: