GAMEREADY Single Day Futsal Clinic Millicent
Registration form
Personal Information
Parent/Guardian
Name
*
First Name
Last Name
Email
*
example@example.com
Age Group
*
8-11 Year Old
12-14 Year Old
Please select day:
Friday October 2nd (9:30am - 2:00pm) - MILLICENT BASKETBALL STADIUM
Player details
*
Has any player been identified as living with a disability?
*
Yes
No
Please specify
*
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Please buy a ticket for each registered player
$55.00 AUD
$
55.00
AUD
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
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Expiration Year
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