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Nomination for an Event - Please fill in all details below.

A Confirmation email will be sent to you once your nomination has been accepted

Payment can be made by Direct Debit    BSB: 036-168        Account Number: 483872  (New Bank Account Number)

Please Reference Your Name & the Event you are paying for when paying by Direct Debit (internet banking)

Please make 1 Payment for Whole Team

Credit/Debit Card by EFTPOS at the club or Cash on the day

Fields marked with * are required.