September 2010


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Registration

Please complete all applicable details below to register for the 2010/11 ECB Softball season.  Once you have clicked on the "submit registration" button you will be taken through to the payments options page.  If you wish to print out and complete your Registration for posting, then please click here to download the form.

If you have any questions click here to contact the ECB Softball Committee.

East Coast Bays United Softball Club and North Harbour Softball Association
2010/2011 Softball Member Registration Form

First Name
                   
Last Name

Male     Female

Junior Players Only:

Date of Birth    

School            

Parents/Guardians Names:

Caregiver 1    

Caregiver 2   

Postal Address:

Address line 1            
   
Address line 2

Suburb
City                                                          
   
Post Code

Residential Address (if different from above):

Address line 1            
   
Address line 2

Suburb
City                                                          
   
Post Code

Home Phone

Work Phone

Mobile Phone                   
       
Email Address

Medical Conditions

Occupation (Senior players)

Occupation of caregivers (Junior players)

Ethnic Identity

Iwi

Consent
Yes   No
I consent to the collection of the above details by NHSA and East Coast Bays United Softball for administration purposes and for NHSA and East Coast Bays United Softball to retain, use and disclose these to Softball New Zealand, Funding Agencies or Sponsors. I acknowledge my right to the access and correction of this Information. This consent is given in accordance with the Privacy Act 1993 and amendments.

Signed by

East Coast Bays United Softball Club information required:
Playing History
First Year Played   

Club Last Season       

Grade Last Season
Team Last Season

Players & Parents:
Our Club and NHSA are run entirely by volunteers, if you can help in any way including the following please indicate in the box or information section below:
Coaching
Umpiring
Scoring
Team Manager

Any other information:



Payment Information
Please advise how you are planning to pay the registration fees as we are offering both internet banking and cheque payment this year, so need to ensure we can match payments.

I am paying by
Internet banking
Cheque
Other