U18 Selection Trials - ________________________________ (name of Participant)
Please Print off, scan & email to firstname.lastname@example.org or post into the office - BWHA, 16 Melbourne Street, Windsor, Qld 4030.
Trial Cost - $45.00. BWHA accept the following:
1. CASH - at the office (no payment accepted at the trials)
2. CHEQUE - made payable to Brisbane Womens Hockey Assoc and mailed or handed in at the office.
3. DIRECT DEBIT - Brisbane Womens Hockey Assoc
4. CREDIT CARD - manually processed in the office (1% surcharge will be added to total). Please email details:
Name on Card: ______________________________________
Card Number: ________ ________ ________ ________
Expiry Date: ____ / ____ CSV#: _______________ (3 digits on back of card)
Total Amount Paid: ____________________
NB: All players must be financial with their Club to be eligible to nominate for Brisbane. BWHA can not accept unfinancial players at Aged Selection Trials.