Online Form - Leisurelife Adult Team Sports Registration

Leisurelife	Gym
Monday - Thursday	5:30am - 8:30pm
Friday	5:30am - 8pm
Saturday	8am - 6pm
Sunday	8am - 4pm

Aqualife	Gym	Pool
Monday - Friday	5:30am - 8:30pm	5:30am - 8:30pm
Saturday and Sunday	7am - 5pm	7am - 5pm

Team Name*

Team Status*

Existing team / previously played
New team

Nominated Competition*

Monday Basketball (Open)
Monday Futsal (Mixed)
Monday Rebound Soccer (Open)
Tuesday Basketball (Open)
Tuesday Basketball (Mixed)
Wednesday Basketball (Open)
Wednesday Netball (Ladies)
Wednesday Netball (Mixed)
Thursday Basketball (Open)
Thursday Netball (Ladies)

Grade Preference (Please note: Whilst we endeavour to place your team in the nominated grade, final selection is at the discretion of management*

A
B
C
D
E

First Contact - Full Name*

First Contact - Mobile Number*

First Contact - E-mail Address*

First Contact - Postcode*

Second Contact - Full Name*

Second Contact - Mobile Number*

Second Contact - E-mail Address*

Player 1 - Full Name

Player 2 - Full Name

Player 3 - Full Name

Player 4 - Full Name

Player 5 - Full Name

Player 6 - Full Name

Player 7 - Full Name

Player 8 - Full Name

Player 9 - Full Name

Player 10 - Full Name

Photographic Consent - As Team Coordinator, I hereby give the Town of Victoria Park, and its officers and contractors, permission to take photographs of the players and spectators for my team(s) which may be used on the Town website, social media and any promotional material distributed by the Town from this date forward.*

As Team Coordinator, on behalf of my team, I give permission
As Team Coordinator, on behalf of my team, I do not give permission

How did you hear about our competitions?*

Played here before
Word of mouth
ToVP website
Contacting Leisurelife
Facebook
Other

Code of Conduct Declaration*

As Team Coordinator, I confirm that my team will abide by the Leisurelife Centre Bylaws and Code of Conduct for my nominated sport.