Junior Member - Walkout Registration Expression of Interest

The Central Coast Mariners are offering Junior Members the opportunity to participate as a walk-out mascot for the Hyundai A-League 2019/20 Season. Please submit your registration of interest below. All details must be completed in order to submit a valid entry.

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* 1. Please complete the following details of the Junior Member looking to apply

First Name

Last Name

Address

Suburb

State

Postal Code

Email Address

Phone Number

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* 2. Please enter your Member Number

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* 3. Which Junior Membership type do you hold?

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* 4. Preferred Shirt Size

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* 5. Accompanying Parent Name & Phone Number

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* 6. By completing this form, I agree that I understand the Terms & Conditions surrounding this promotion. Junior Members are selected at random 2 weeks prior to the match, and have 5 days to confirm their attendance. Should they not confirm via E-Mail or SMS, their position will be made available to the next selected Junior Member. I can confirm the contact information that I have provided is correct.

I agree