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* 1. Details

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* 2. Date of Birth

Date of Birth

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* 3. Have you participated in female football previously, if so what level?

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* 4. What year did you last participate in football?

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* 5. Below is a list of WRFL member clubs. Please indicate the club(s) you have an interest to join.

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* 6. Do you approve of your contact details being shared with the WRFL club selected above?

T