Please complete to register your interest to trial/play for 2017 NSBHA field representative teams.


Choose Team for Trial
Player's Name *
Player's Name
Date of Birth *
Date of Birth
Please leave space between no. ie xxxx xxx xxx
Parent/Guardian's Name
Parent/Guardian's Name
Please leave space between no. ie xxxx xxx xxx
If you would like another contact to receive details enter here.
List both junior club & senior club, if different.