Juniors Registration – Summer 2023-24

    Please complete all information in the below Juniors Summer 2023-24 registration form. Payment details will be emailed to you once your registration has been processed by the Registrar.

    Player Details

    First Name:

    Surname:

    Date of Birth:

    Gender:
    MaleFemale

    Address Details

    Parent/Guardian 1 Details:

    Parent/Guardian's Name:

    Relationship to Player:

    Phone:

    Email:

    Parent/Guardian 2 Details (Optional):

    Parent/Guardian 2 Name:

    Relationship to Player:

    Phone:

    Email:

    Would you like to use the Active Kids Voucher?:

    The voucher number is:

    If you have any special requests in relation to team preference please state along with your reason. (Leave blank if you have no special request.)

    PLEASE NOTE: The Falcons will endeavour to fulfill requests but cannot guarantee to do so as our priority is the creation of well balanced, competitive teams that meet RHBL guidelines.

    I have read and agree with the Five Dock Falcons Juniors Terms and Conditions and Code of Conduct.