2021 Hookin2Hockey Program registration

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? *
What date and time does your program start? *

Month Day Year
Date
Hour Minutes 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 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.
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