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* 1. Players Name

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* 2. Players Gender

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* 3. Players DOB

Date

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* 4. Players Current School

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* 5. Is your child a New Zealand Citizen?

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* 6. Which club team (e.g Tikipunga AFC) is your child registered with in 2021?

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* 7. Parent/ Guardian Contact 1

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* 8. Parent/Guardian Contact 2

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* 9. Please Provide 1 Sporting Reference (Sports Teacher, Club Coach etc.)

Note: This person may be contacted to discuss your registration

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