Fields marked with * are required.

Online payment option available upon completion of this form.
mastercard visa

Please select:


PriceQuantity
Senior Men's $200.00
Senior Women's $200.00
Horowhenua College Boys $75.00
Horowhenua College Girls $75.00
Waiopehu College Boys $75.00
Waiopehu College Girls $75.00
13th Grade (Year 8) $40.00
12th Grade (Year 7) $40.00
11th Grade (Year 6) $40.00
9th/10th Grade (Year 4/5) $25.00
7th/8th Grade (Year 2/3) $25.00
First Kicks (Pre-school/Year 1) $25.00
Coach/Manager $0.00
Total $0.00