2021 Hookin2Hockey Program registration
**Programs must be registered 5 weeks in advance to receive paid social media support**
Club Name
*
Which State or Territory is your club associated with?
*
Please Select
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
What date and time does your program start?
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
How many weeks will your program run for?
Will your club run a second program in the same term?
*
Yes
No
What date and time does your second program start?
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Program Location
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Coordinator's Name and Email
*
Coordinators phone number
*
What will your club delivery fee be? Club Deliverer fee is recommended to be $30 however you can choose between $0 - $150
*
There will be a Hockey Australia component of $15 and a State Member component (from $15 - $25) per registration, on top of your club delivery fee.
Submit
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