Pink Magic Netball Club Inc by huangyuarong

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									                                    Pink Magic Netball Club Inc.
                                     Incorporation No. IA38610

                                    P.O. Box 526 Capalaba Qld 4157

                                    Phone: 0457 244 053
                                    Email: contact@pinkmagicnetball.com.au
                                    Web: www.pinkmagicnetball.com.au

             2012 Player Registration Form
PLAYER DETAILS – Separate Form is required for each Player.

Family Name: ____________________________ First Name:____________________________

D.O.B:__________________________ School Attended:________________________________

PARENT/GUARDIANS DETAILS

Parent/and or Guardian No 1:______________________________________________________

Address:_______________________________________________________________________

Phone:____________________Work:____________________Mobile:_____________________

Email:_________________________________________________________________________

Parent/and or Guardian No. 2:_____________________________________________________

Address:_______________________________________________________________________

Phone:____________________Work:____________________Mobile:_____________________

Email:_________________________________________________________________________

Who is responsible for payment of all Fees:___________________________________________

Are there any family circumstances the Club needs to be made aware of:
Details:______________________________________________________________________
POSITION PLAYED

Have you played Netball before: YES or         NO     (please circle)

What positions have you played: __________________________________

Preferred Positions: No. 1 _______________ No. 2__________________




FAMILY INFORMATION

It will be compulsory for all Families to assist at Club Duties, Fundraising Events and Carnival
Days.

Are you, your business, employer or any person you may know be in a position or willing to be
able to sponsor/donate funds to help with the costs associated with the commencement and
continued costs of running Pink Magic Netball Club Inc.

Details:____________________________________________________________________



UMPIRING/COACHING

Are you or your Child interested in representing Pink Magic Netball Club Inc. as an Umpire or
Coach. YES or NO (please circle) UMPIRE or COACH (please circle)

Do you hold any qualifications in Umpiring or Coaching? YES or NO (please circle)

Details:__________________________________________________________________



Are you interested in attending any courses (fully funded by Pink Magic Netball Club Inc.

and as approved by the Executive Committee) relating to Umpiring or Coaching?

YES or NO (please circle)
REGISTRATION FEES



Junior (Saturday) Registration Fee Player 1: $220.00 each player

Senior (Monday Night) Registration Fee Player 1: $230.00 each player



Each Netball Family will be subject to an ADDITIONAL FEE of $55.00 - FUNDRASING LEVY 2012

This Levy after payment will be reimbursed dependant on hours of work committed to Fundraising to
the Pink Magic Netball Club 2012 season. (This does not include RNA specified Club Duties)



Registration Fee (additional Family Member Junior Saturday Comp): $200.00 each player

Registration Fee (additional Family Member Monday Night Comp): $210.00 each player



Registration Fee Includes: Redlands Netball Association Registration Fee, Insurance Fees, Umpiring
Fees, Team Photos/Trophy and Presentation Day.



Copy of Birth Certificate Attached:   YES or    NO (please circle)



Payment Details: Cheque/ Eft/ Credit Card

EFT: Bank of Queensland - please use your name as the reference

Account: Pink Magic Netball Club BSB: 124 024 Account No: 21 548 922



Credit Card will be available on the 4th February Sign On Day Only
MEMBERSHIP INFORMATION

   Pink Magic Netball Club Inc. abides by the By-Laws and Constitution of the Redlands
     Netball Association, and these can be assessed at www.redlandsnetball.org. By signing
     this form you agree to abide by these By-Laws and Constitution and any other rules or
     regulations as set down by the Pink Magic Netball Club Inc.


   I agree to abide by the Code of Conduct as set out by the Redlands Netball Association
     (available at their website) and as designated by Pink Magic Netball Club Inc.


   I agree to release information to the Coach of my Child and as requested by Pink Magic
     Executive.


   I agree that the Pink Magic Netball Club Inc. may organize to take photographs/videos
     as requested to be used for Promotional Material only and placed on the Pink Magic
     Netball Club Inc. Official Website, Facebook Site or as required by the Redlands Netball
     Association.
PARENT & PLAYER AGREEMENT




PARENT/GUARDIAN NO.1:
_________________________________    ___________________________________

SIGNATURE                            NAME



PARENT/GUARDIAN NO.2:
________________________________    _____________________________________

SIGNATURE                           NAME



PLAYER:
_______________________________     _____________________________________

SIGNATURE                           NAME



_____________________

DATE
       MEDICAL FORM



The following information is intended to assist the Pink Magic Netball Club Inc., Coaches and
Team Officials. In case of any medical emergency or absence of parent or guardian this form
will be made available for any medical assistance required. This form will be kept on file as a
sensitive document with each team coach at all games and at all carnivals.

I hereby authorize the Pink Magic Netball Club Inc. and its volunteers to act on my behalf
should my child require any medical attention.

I hereby release the Pink Magic Netball Club Inc. from all/any liability for injury or incident
incurred by my child.



IN CASE OF AN EMERGENCY PLEASE CONTACT:

Parent/Guardian’s Full Name:____________________________________________________

Phone:_________________ Work: ________________ Mobile:_______________________



Second Emergency Contact:



Parent/Guardian’s Full Name:____________________________________________________

Phone:_________________ Work:_________________ Mobile:________________________
Medicare Number:__________________________ Private Health Fund:__________________



Does your Child suffer from any allergies/medical conditions:

Details:______________________________________________________________________

____________________________________________________________________________

Is your child taking any regular medication: YES or NO (please circle)

Please state name of Medication and Dosage

Details:_____________________________________________________________________



Is your Childs Tetanus Vaccination up to date: YES or NO (please circle)

IN CASE OF AN EMERGENCY AN AMBULANCE WILL BE CALLED



PARENT/GUARDIAN NO.1:
_________________________________           ___________________________________

SIGNATURE                                    NAME



PARENT/GUARDIAN NO.2:
________________________________            _____________________________________

SIGNATURE                                   NAME

DATE:_____________________

								
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