Individual Registration

Please enter information in the form below to process registration for event Canberra Senators 2020 Pan Pac Masters Games.

Username*

Password*

Retype password*

First name*

Last Name*

Address*

City*

Country*

State*

Postcode*

Phone*

Email*

Date of Birth *

eg; 23-05-1970

Next of Kin Name *

Next of Kin Relationship *

Next of Kin Phone *

I wish to register as a

My preference is to play in

This is my first Pan Pacs

Yes

In providing financial payment to the Canberra Senators I hereby give them permission to register me for the 2020 Pan Pac Masters games. I acknowledge and understand the conditions that the Canberra Senators are registering me under and acknowledge there are no refunds allowed except afforded to me by law.

Payment Method

Paypal

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*

iDeal Bank*

Verification code*

Please enter the code you see in the image into the textbox

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Individual Registration

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New User? Please register

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Member Access