Registrations News Franchises Committee Resources Draw Fixtures & Results REGISTRATION – LIVERPOOL BULLS Step 1 of 3 33% Name(Required) First Last Date of Birth(Required) DD slash MM slash YYYY Phone Number(Required)Email(Required) Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Health InformationEmergency Contact(Required) First Last Emergency Contact Phone Number(Required)Do you suffer from any allergies? Are there any previous sports injuries we should be aware of? Playing HistoryHave you previously played in any ISNSW Superleague competitions, or competed at State Representative level?Previous Superleague Division? Previous Superleague Clubs? Previous State Representative Experience? UmpiringCan you umpire at a Superleague level? Yes I'm capable and suitable to umpire.Do you want to umpire? Yes I would like to volunteer to umpire.WWCCDo you hold a current NSW Working with Children Check? Photography and Social Media ConsentPhotography & Social Media(Required)Liverpool Bulls, ISNSW Superleague, Indoor Sports NSW and Member Centres, will from time to time, seek to photograph, record on video and live stream Superleague competitions, for the purposes of promotion and advertising. By consenting to this agreement, you agree that images of you can be used by the club (and affiliated organizations), in this manner. I consent to images of me being used for promotional purposes. Team NominationPlease choose the divisions you wish to nominate for. Liverpool Bulls 2021 Season Fees Senior $110.00 Junior $65.00 Second Team Fee $25.00 What division would you like to nominate for?(Required)This will be your first choice team nomination Ladies (Div 1-6) Mens Mixed (Div 1-5) Juniors (U10 - U15) Preferred Division/Team? Would you like to nominate for an additional team/division?This is for a second team nomination fee. No Second Team Ladies (Div 1-6) Mens Mixed (Div 1-5) Juniors (U10 - U15) Preferred Division/Team? Total Fees Due for 2021 Credit Card(Required) American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Security Code Cardholder Name SUBSCRIBE FOR SUPERLEAGUE NEWS & UPDATES Success! First Name Last Name Email Subscribe
