Slowpitch New Zealand - Northern League

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Individual Registration Form - NORTHERN LEAGUE

First Name(*)

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Last Name(*)

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Date of Birth

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Street

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City

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Postcode

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Mobile Phone

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Daytime Phone

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Evening Phone

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Last Years Team

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to be filled out IF you have played the previous season

Gender

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Individual registration fee

If paid prior to October 7th

N/A

Team registration fee

If paid prior to October 7th

N/A

Bank account information

N/A

Reference

Your last name/ team name

Softball Experience

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To assist us in placing you on a team, please indicate your level of softball experience

Amount Paid $

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Anti Spam(*)

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Please type the letters in the box above as they appear on your screen