Registration form

Athlete's details

* Indicates required field

Name of athlete *

First

Last

Date of birth *

Athlete's email *

Athlete's phone number *

If athlete is under 15

Name of parent(s) *

Parent's email *

If athlete is 15 or over

Contact person(s) for emergencies *

Emergency contact's phone number *

Medical conditions of which we should be aware *

Parent's phone number *

Submit

Payment of club fees to be made to account 03-0830-0690768-000
Payment for Singlets/Jackets/Crop tops can be made on line to Phoenix Athletic Club – Westpac - 03-0830-0690768-00

Please pay all registration money to the club and we will pass it on to the different organisations as required.