Please Fill out Form and return by February 27th. * indicates required Email Address * Name of Juvenile Chairperson * Contact No. Juvenile Chairperson * Name of Juvenile Secretary * Contact No. Juvenile Secretary * Name of Club Coaching Officer * Contact No. Coaching Officer * Name of U8 Lead Mentor * Contact No. U8 Lead Mentor * Approximate No. of Players U8 * 1-1213-2021-30Over 30 Name of U10 Lead Mentor * Contact No. U10 Lead Mentor * Approximate No. of Players U10 * 1-1213-2021-30Over 30 Name of U12 Lead Mentor * Contact No. U12 Lead Mentor * Approximate No. of Players U12 * 1-1213-2021-30Over 30 Name of U14 Lead Mentor * Contact No. of U14 Lead Mentor * Name of U16 Lead Mentor * Contact No. of U16 Lead Mentor * Name of U17 Lead Mentor * Contact No. of U17 Lead Mentor * Name of U18 Lead Mentor * Contact No. of U18 Lead Mentor * State if your club is part of an Amalgamation * Give the age group(s) * Name of the Amalgamations *
