EMAIL ADDRESS Club / BERMUDA SENIOR PLAYERS REGISTRATION FORM Club FULL NAME OF PLAYER SURNAME PLACE OF BIRTH FIRST MIDDLE DATE OF BIRTH MONTH HOUSE NAME AND STREET HOUSE / /
Position
SECRETARY / PLAYER / above named player / PRESIDENT OR SECRETARY OR ASSISTANT SECRETARY / /
PLAYER REGISTRATION # (for official use only) Registration # ______________ P.O. BOX HM 992, HAMILTON HM DX, BERMUDA