Name ________________________________________________________________

Address______________________________________________________________

____________________________________________________Post Code_______

Phone No (H)______________ (W) ______________ (Mob.) _______________

email _________________________________________

Date of Birth __________________ Height _________________

Preferenced playing positions 1 _______ 2 __________ 3 _______

Previous playing experience

Name of Club _________________________________________________

Grade played ____________                           Year ______

Where did you hear about the trial : ____________________________________

Additional details

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

I acknowledge that netball is a vigorous physical sport and that injuries can be sustained as a result of participation. I agree to trial and play for the Club entirely at my own risk. I also agree to fully indemnify the Club against all costs, claims or demands incurred by or brought by or against the Club arising in any way, whether through injury or otherwise, as a result of my playing for the Club.

Signed_____________________________________