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* 1. Name

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* 2. Email address

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* 3. Mobile number

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* 4. If under 18, please advise guardian's name and contact number

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* 5. Date of birth

Date

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* 6. Preferred grade to play 2021 season

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* 7. Preferred position

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* 8. In 2019/2020 did you play for another club - if so please advise previous club name [if applicable]

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* 9. Are you a member of Souths Leagues Club - if so please advise your membership number

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* 10. Would you be interested in any available positions within the club [executive, coach, manager or MHA representatives], if so please advise

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