Wild Atlantic Way - West Cork

Coaches/Players register form

please fill out the form and send a photograph of yourself and one of your passport to info@ballyroe.org or to 087 613 9364

Family name

First name

Date of birth (day, month, year)

Role

Player

Coach

Team (U?, Juniors etc)

Address

EirCode

Phone number

Email

Message

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Note: Please fill out the fields marked with an asterisk.