WUFC Form Test – Are you with us?

WUFC School's Out 2020 Holiday Program

Register your child today to take part in one of our January sessions.- Please note there is a limit of 96 places for each location -

Details - Step 1 of 2

Player's details

How many players do you want to register? *

Player 1

Player 1: Name *

Player 1 Date of Birth *

Player 1: Gender *

Male
Female

Player 1: Ambulance Cover? *

Yes
No

Player 1: Registered with a club?

Yes
No

Player 1: Name of registered club

Player 1: Shirt Size *

Player 1: Medical Conditions *

Please state any medical conditions and allergies we should be aware of e.g. asthma, epilepsy, nut allergy, hayfever etc

Player 1: Registration Fee *

Price: $ 50.00

Player 2

Player 2: Name *

Player 2: Date of Birth *

Player 2: Gender *

Male
Female

Player 2: Ambulance Cover? *

Yes
No

Player 2: Registered with a club?

Yes
No

Player 2: Name of registered club

Player 2: Shirt Size *

Player 2: Medical Conditions *

Please state any medical conditions and allergies we should be aware of e.g. asthma, epilepsy, nut allergy, hayfever etc

Player 2: Registration Fee *

Price: $ 50.00

Player 3

Player 3: Name *

Player 3: Date of Birth *

Player 3: Gender *

Male
Female

Player 3: Ambulance Cover? *

Yes
No

Player 3: Registered with a club?

Yes
No

Player 3: Name of registered club

Player 3: Shirt Size *

Player 3: Medical Conditions *

Please state any medical conditions and allergies we should be aware of e.g. asthma, epilepsy, nut allergy, hayfever etc

Player 3: Registration Fee *

Price: $ 50.00

Parent's details

Parent's Name *

Mobile Number *

Email *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Emergency Contact Name *

Emergency Contact Number *

Are you a WUFC club member?

Yes
No

Terms of Service *

Yes, I agree.

Have you read and agree to the Terms of Service?

Return Policy *

Yes, I agree.

Have you read and agree to the Return Policy?

Total

$ 0.00

Stripe Credit Card *

Card

Name on Card

Your payment is safely processed with Stripe.

Total

$ 0.00

Name