Sandringham Soccer Club - Register to Play

To register to play, print and complete a hardcopy Registration Form, or complete an online Registration Form below.

Note to direct debit payers: During the course of completing this form, you will be required to pay the total membership fee and obtain a receipt number to complete the Payment Details section below.

Note to credit card payers: Unfortunately our Bank’s Credit Card Payment Facility is not yet available. If you would still like to pay by credit card, you will be required to print, complete and mail a hardcopy Credit Card Payment form available below.

SECTION 1: Player's Details

Player 1

Surname *

First/Preferred Name *

Health Care Card Number

Gender *

FemaleMale

Date of Birth *

/ /

Age Group

Team Preference *

Friends you would like in your team

Passport or Birth Certificate Number

Medical Conditions
eg: asthma, allergies

Player's Mobile Number

Player's Email *

SECTION 2: Guardian Details

Parent 1 / Guardian 1 - Primary Contact
Surname *
First/Preferred Name *
Mobile Phone Number
Email *

Parent 2 / Guardian 2
Surname
First/Preferred Name
Mobile Phone Number
Email

Address Details
Home Street Address *
Suburb *
Postcode *
Home Phone Number *

SECTION 3: Help / Volunteer

Can you help in the running of this 800 playing member club?
I'd be interested in being a *

Would you like to be on the Club's register of providers of a service or product? If yes, please provide details.

SECTION 4: Registration Fees

Age Group	Eldest Player in family must pay full fee	Family Discount: 2nd and subsequent players	Concession Card Discount	Total No. Players
GoalKick (U5 - U6)	$125	$100	$88
U7 - U8	$175	$140	$123
U9 - U10	$200	$160	$140
U11 - U17	$250	$200	$175
U18	$270	$216	$189
Open	$320	$256	$224
				Total:

SECTION 5: Payment Details

Payment Options *

Date of Payment * / /

I have read and agree to abide by the terms & conditions and the code of conduct.

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Sandringham Soccer Club
ABN 56 440 282 148 Email info@SandringhamSoccerClub.org.au
All correspondence to The Secretary, Sandringham Soccer Club, PO Box 11, Hampton, Victoria 3188
© Sandringham Soccer Club 2007. All rights reserved.

Administration Page