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Wednesday Mixed Day League Nomination Form
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Mobile Number
*
Email
*
Which Club are you from?
*
Full time player or reserve?
*
Full time
Reserve
If reserve, please outline dates available:
No supper player?
*
Yes
No
Must still stay for the duration of all matches.
Any dietary requirements?
Additional information that may help with you placement in a team (away for any length of time, etc):
Comments or Questions
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