Contact Us
Phone
Email
drjfc@outlook.com
Address
Plumpton Road, Diggers Rest 3427
Sponsor Enquiry
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Home
Fixtures
Club Song
Games Played
Honour Board
Trophy Room
Events
Contact
Club Registration Enquiry
Club Registration
*
Please Select
Football
Netball
Football & Netball
Football Age Group
*
U9
U11
U13
U15
U17
Youth Girls (Football Only)
Training Top Size
*
Name on Back of Top
*
Jumper Size (Football)
Dress Size (Netball)
Player Information
Current Player
New Player
Player's Name
*
Date of Birth
*
Address
*
Siblings at the Club?
*
Yes
No
How many siblings at the club?
Parent Information
Name
*
Address
*
Mobile Phone
*
Email Address
*
Medical Information
Does this player have any medical conditions, including illness, disability or allergies?
*
Emergency Contact
*
Relationship
*
Mobile Phone
*
Ambulance Subscription
*
Yes
No
Member Number
In an emergency, where prior notification has not been possible, you authorise the club to arrange any necessary medical treatment for the above player
Payment Details
FOOTBALL | U9 Football $220 - All Other Ages $300
NETBALL $220
FOOTBALL + NETBALL $340
$10 Non-Refundable Deposit Paid
Get Active Code Voucher
Family Discount
Portion of Fee Already Paid
*
Socks | $15 - Include Size & Quantity
*
Shorts | $35 - Include Size & Quantity
*
Balance
Amount Owing $
*
Payment Plan
Registered on PlayHQ
Social Media
I consent to my child’s photos/videos being published on DRJFNC social media platforms
*
Additional Notes | Please Indicate if you would like a Payment Plan and whether the player is registered on PlayHQ
* Required fields
