Seniors Winter 2022 Registration Form

    Please complete all information in the below Seniors Winter 2022 Registration Form. Payment details will be emailed to you once your registration has been processed by the Club Registrar.

    Player Details

    First Name:
    Surname:
    Date of Birth:

    Gender:

    MaleFemale

    Contact Details

    Mobile:
    Email:

    Address Details

    Playing History

    Have you played baseball at adult level?: YesNo
    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.

    Personal

    Occupation:
    Registering for discount: Full-time studentUnemployedPensioner
    Name of school or other educational institution if registering as a full-time student:

    PLEASE NOTE: Proof of student / unemployed / pensioner status may be required to enable discount.


    Would you like to use the Active Kids Voucher?:
    The voucher number is:


    Emergency Contact

    Name:
    Mobile:

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