AFL Canberra Holiday Program - Registration Form 12yo+

Which program would you like to register for? *
Participant Name *
Date of Birth *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Parent/Guardian Contact Number *
Parent/Guardian Name *
Parent/Guardian E-mail Address *
Participants School? *
Are you currently registered to play with an AFL NSW/ACT Club? *
If so, where?
Are you happy to receive communications from AFL NSW/ACT in relation to upcoming programs, offers, promotions and other forms of communication? *

AFL Canberra Holiday Program – Registration Form 12yo+