KICKSTART Single Day School Holiday Clinic - Summit Sport and Recreation Park
Registration form
Personal Information
Person Responsible for child
Name
*
First Name
Last Name
Email
*
example@example.com
Age Group
*
5-9 Year Old (single day)
Please select day:
Single Day - 7th July (9:30am - 1:00pm)
Single Day - 13th July (9:30am - 1:00pm)
Player details
*
Has any player been identified as living with a disability?
*
Yes
No
Please specify
*
RAA Member Number (if applicable)
Where did you hear about the program?
*
Please Select
Social media
Email
Word of mouth
Radio
Tv adverts
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KICKSTART Single Day School Holiday Clinic - Summit Sport and Recreation Park
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Single Day (5-9 Years old)
$55.00 AUD
$
55.00
AUD
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Debit or Credit Card
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Last Name
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