southwestsoccer.com.au

HPC Registration for Assessment

	The FFSW High Performance Centre, under Technical Direction of Mr Paul Wozny, is pleased to be taking registrations for Term Three 2010 for player development programs.
	Please use the form below to register your player for HPC Assessment.
	This Registration Form is for players born in 1996 through to 2001.
	Your player will be invited to a HPC session where they will be assessed and allocated to the appropriate squad to ensure their best possible opportunity to progress.
First Name	Invalid Input
Surname (*)	Invalid Input
Date of Birth (*)	Invalid Input	14/02/1996
Gender (*)	MaleFemale Invalid Input
Club Registered in 2010 (*)	Invalid Input
Parent or Guardian Name (*)	Invalid Input
Address Line 1 (*)	Invalid Input
Town/Suburb (*)	Invalid Input
Postcode (*)	Invalid Input
Home Phone	Invalid Input	9799 9999
Mobile Contact	Invalid Input	0499 999 999
Parent Email Contact (*)	Invalid Input
	You will receive an email shortly from Mr Paul Wozny confirming your assessment details.
Preferred Venue	Bunbury - Bunbury Catholic College, Rodstead St Busselton - Churchill Park, Adelaide St Margaret River - Western Oval Invalid Input
Submit