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Address 1
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Address 2
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Player Surname
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/home3/darren/public_html/clubs/assets/includes/registration.php on line
891
" size="10" class="contact_inp_text_c marn_2" name="surname2" id="surname1"/>
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Player First Name
:
/home3/darren/public_html/clubs/assets/includes/registration.php on line
897
" size="10" class="contact_inp_text_c marn_2" name="firstname2" id="firstname1"/>
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Parent/Guardian Surname
:
/home3/darren/public_html/clubs/assets/includes/registration.php on line
903
" size="10" class="contact_inp_text_c marn_2" name="gsurname2" id="gsurname1"/>
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Parent/Guardian First Name
:
/home3/darren/public_html/clubs/assets/includes/registration.php on line
909
" size="10" class="contact_inp_text_c marn_2" name="gfirstname2" id="gfirstname1"/>
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Address 1
:
/home3/darren/public_html/clubs/assets/includes/registration.php on line
916
" size="10" class="contact_inp_text_c marn_2" name="address12" id="address11"/>
Address 2
:
/home3/darren/public_html/clubs/assets/includes/registration.php on line
921
" size="10" class="contact_inp_text_c marn_2" name="address22" id="address22"/>
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Mobile Number
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/home3/darren/public_html/clubs/assets/includes/registration.php on line
927
" size="10" class="contact_inp_text_c marn_2" name="cell2" id="cell1"/>
Home Number
:
/home3/darren/public_html/clubs/assets/includes/registration.php on line
933
" size="10" class="contact_inp_text_c marn_2" name="land2" id="land1"/>
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League Name
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Team
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Player Registration Fee
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I, the child's parent/guardian, give permission for the club to use our child's picture on their website.
