Homebush West Public School Registration Form

Please fill in the registration form or download a copy and return via email.

Registration Form PDF

Important Documents

Code of Conduct

Duty of Care

Photography and Privacy

Terms and Conditions

Player Information

Player Name *

First

Last

Date of birth *

Gender *

Age *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Parent / Guardian Information

Parent / Guardian Name *

First

Last

Relationship to Child *

Parent / Guardian Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Parent / Guardian Mobile *

Parent / Guardian Home Phone

Parent / Guardian Email *

Parent / Guardian Work Phone

Emergency Contact Information

Please fill out if different from above

Emergency Contact Name

First

Last

Relationship to Child

Emergency Contact Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Emergency Contact Phone

Emergency Contact Email

Medical Information

Does the player have any known medical conditions, injuries, or allergies?

Any additional information?

Player Declaration *

I acknowledge that in any sport serious injuries can occur. I hereby declare that I will abide by the LUMIN8 FOOTBALL Code of Conduct. I agree to release LUMIN8 FOOTBALL and its employees from any liability in relation to injury, loss, or damage.

Parent / Guardian Declaration *

I authorise the qualified and trained staff at LUMIN8 FOOTBALL to provide such medical assistance on my behalf that my child may require if deemed necessary.
I have read and acknowledged the Code of Conduct, Duty of Care, Photography and Privacy, and Terms and Conditions documents and accept the requirements of LUMIN8 FOOTBALL.

Important Documents

Player Information

Parent / Guardian Information

Emergency Contact Information

Medical Information

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