St. Patrick's Emerald City GAA - Registration 25/26

Social Registration is now open

Name

First Name

Last Name

Contact Number

Country

(###)

###

####

Date of birth

YYYY

Gender

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Returning Member?

Type

Emergency Contact Details

Name of emergency contact

(###)

###

####

Number of emergency contact

Country

(###)

###

####

Medical information - Please share any important medical info for emergencies (like allergies, conditions, or medication).

This is strictly confidential as per our constitution and The Incorporated Societies Act.

Physio & First Aid

Would you be willing to provide physio or first aid assistance during training or on match day if you have the skills?

Please send your registration fee of $35 to 38-9025-0232861-00

I have sent

Notes

By completing this form - I agree to signing up as a social member for the 24/25 season - I am aware that my photograph or video may be taken while participating in club event's (training, social's etc.) - I agree to follow the club code of behavior, available here - https://www.stpatsec.com/join-us

Agree