Player Details
First Name   Last Name   Sex:
Date of Birth   Phone:   Mobile:
Email Adress  
Address
 
Suburb Post Code
Parent/Guardian Name  
Parent/Guardian Mobile Parent/Guardian Email Address  
Are you a Mingara Club Member ? Membership No
Player History
Current Club Grade/Team Played in 2011
Positions Played 1.   2.
Player Rep History
Rep Team Information
Preferred Positions 1.                2.                3.
Select Team(s) you are trying out for.
     
Admin only information