Membership Form
Please use BLOCK LETTERS and answer all questions
Please also not any medical condition which may affect your play
Name: Sex:
Address:
Ph/Fax/Mobile:
Email address:
Occupation/School:
Club name:
Category of commitment to the NSW Floorball League: (please circle applicable boxes)
|
NSW Floorball League |
AFA member |
Coach
|
Announcer |
Promotions |
Otherplease specify |
|
Player |
Scorer |
$ collector |
Coach |
Referee |
Volunteer |
Signature (of player or parent/guardian) agree to pay full fees:
|
|
day |
mth |
2002 |
|
|
Date received |
Amt AFA fees |
Match fees |
Receipt # |
initial |
|
|
/ /2002 |
|
|
|
|
