Reimbursement Form - The Official Woolgoolga Diggers Website

Woolgoolga Seahorses JRL Registration Reimbursement Form

"*" indicates required fields

*This form must be submitted by the parent/guardian who completed the child’s registration.

NRL ID Number*

* Please insert number only

Player's Full Name*

Age*

Parent's Full Name*

Contact Number*

Email Address*

BSB*

Account Number*

* Please ensure the account number is correct

Bank Account Name*

* Please ensure account name matches banking details

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