2015 senior and collegiate registration form

P O Box 437,
Remarie Kapa Drive,
Kerikeri 0245.
http://www.kerikerinetballcentre
Email:
[email protected]
2015 SENIOR AND COLLEGIATE
REGISTRATION FORM
Return by Friday, April 17, 2015
to P O Box 437, Kerikeri 0245
Season Starts Saturday, 2 May
Registration Fee: Senior $600.00 Collegiate $450.00
Fees must be paid in full by the start of the season
Payment methods:
Direct Credit: ASB Account 12 3091 0064926 00 (please state team name/club/invoice details as reference)
Cheque: Payable to the Kerikeri Netball Centre
Team Name:
____________________________________________________________________
Team Colours:
____________________________________________________________________
Name of Club/School:
____________________________________________________________________
Mailing Address:
____________________________________________________________________
Email Address:
____________________________________________________________________
We, ………………………………………………………………………………………………….. Club have read,
understood and agree to abide by the Kerikeri Netball Centre’s Regulations
We also understand that from time to time the Kerikeri Netball Centre may place photos of its
members on their website for publicity purposes and we give full authority to allow this to happen.
Team Delegate Name:
__________________________
Signature:
______________________
Please tick:
Yes we would like a copy of Kerikeri Netball Centre’s Regulations.
Have downloaded our own copy from the Kerikeri Netball Centre’s website
www.kerikerinetball.co.nz
Dates to note:
Thursday, March 19
Friday, April 17
Saturday, May 2
Saturday, May 2
Registration available AGM
Senior, Collegiate and Junior Registration return by date
Final day to pay Registration
Season starts
Players Registration
First Name
Last Name
DOB
Address
Email
Phone Number
1
2
3
4
5
6
7
8
9
10
11
12
Level of Team (please circle): Premier A-Grade B-Grade C-Grade
The Kerikeri Netball Centre Committee reserves the right to grade teams and regrade if necessary.
Contacts
Address
Phone
Email
Coach:
Manager:
Umpire 1:
Umpire 2:
Coach/es, managers, and umpires become members of the Kerikeri Netball Centre by association with the above named club.