Name: DOB: Phone Number: Mobile Number: E-mail Address: Emergency contact for trial dates: Please indicate the playing positions you would like to trial for: 1st: 2nd: 3rd: Please indicate the dates you will be attending selections: If you are unable to attend, please give details: Please indicate if (selected) you would be willing to commit to the South Regional team: Please let us know if you do not wish to play in a league team but would like to play socially: Netball experience (i.e. new player, team, club and division played last season or previously): Details of injuries/illness/operations in past 12 months: Any other information (i.e. coaching/umpiring qualifications, first aider, administrator other useful skills?): you be interested in helping with any of the following (or undertaking courses towards): Committee member Coaching seniors – Umpiring Coaching juniors – Captain Other Are you affiliated to another club? Please give details of first & second affiliation:
Name: DOB: Phone Number: Mobile Number: E-mail Address: Emergency contact for trial dates: Please indicate the playing positions you would like to trial for: 1st: 2nd: 3rd: Please indicate the dates you will be attending selections: If you are unable to attend, please give details: Please indicate if (selected) you would be willing to commit to the South Regional team: Please let us know if you do not wish to play in a league team but would like to play socially: Netball experience (i.e. new player, team, club and division played last season or previously): Details of injuries/illness/operations in past 12 months: Any other information (i.e. coaching/umpiring qualifications, first aider, administrator other useful skills?): you be interested in helping with any of the following (or undertaking courses towards): Committee member Coaching – seniors Umpiring Coaching – juniors Captain Other Are you affiliated to another club? Please give details of first & second affiliation:
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