Kwinana Social Volleyball Athlete InformationName* First Last Gender*Please SelectFemaleMaleWhat is your age?*Date of Birth* DD slash MM slash YYYY Email* Enter Email Confirm Email Mobile*Address* Street Address City ZIP / Postal Code Local Government*What Local Government Area do you reside in? City of Canning City of Melville City of South Perth Town of Victoria Park Volleyball WA Membership Status*What is your current Volleyball WA Membership Status? * Please note all athletes that wish to be involved in this program must have a Volleyball WA Gold or Platinum Membership. Platinum Gold Silver No Membership Your VWA membership status must be upgraded in order to register for this program. Please click on the link below to sign in or register on VWA’s Fortix system and purchase a Gold or Platinum Membership. > FORTIX LINK Once you have your membership number please return to this form to register.Emergency Contact InformationEmergency Contact Name*Emergency Contact Relationship*Emergency Contact Email* Emergency Contact Mobile*Association RequirementsReds Membership Agreement*I have read and agree to comply with the Reds Membership Agreement. Yes Policies*I agree to comply with all Association and Club policies. Yes Program InformationPlease choose number of sessions*1 session2 sessions3 sessions4 sessions5 sessions6 sessions7 sessions8 sessionsPlease select the date of the session you will be attending*10 October17 October24 October31 October7 November14 November21 November28 NovemberPlease select the dates of the sessions you will be attending*Please ensure that you have selected the same amount of sessions as above 10 October 17 October 24 October 31 October 7 November 14 November 21 November 28 November 2025 Kwinana Socials - 1 session*Credit Card Fees Apply Price: 2025 Kwinana Socials - 2 sessions*Credit Card Fees Apply Price: 2025 Kwinana Socials - 3 sessions*Credit Card Fees Apply Price: 2025 Kwinana Socials - 4 sessions*Credit Card Fees Apply Price: 2025 Kwinana Socials - 5 sessions*Credit Card Fees Apply Price: 2025 Kwinana Socials - 6 sessions*Credit Card Fees Apply Price: 2025 Kwinana Socials - 7 sessions*Credit Card Fees Apply Price: 2025 Kwinana Socials - 8 sessions*Credit Card Fees Apply Price: Credit Card*Card Details Cardholder Name
