Brisbane Knights Juniors Holidays Skill Clinic Registration Friday 1st October 330-630pm

Brisbane Knights Juniors Holidays Skill Clinic Registration Friday 1st October 330-630pm

Brisbane Knights Sports Complex, 210 Dunn Rd, Rocklea 4106
Parent / Guardian Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

SuburbState

Postcode
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name
Emergency Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Name of Child 1

First NameLast Name
Date of Birth / Age
Football Club registered with if applicable
Date of Birth / Age
Name of Child 2

First NameLast Name
Name of Child 3

First NameLast Name
Date of Birth / Age
Food Allergies
Please outline any medical conditions and medications
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BRISBANE KNIGHTS ACADEMY
3 Hour Skill Session

$15.00 AUD Quantity

Total

$0.00 AUD
PAYMENT

Bank Transfer

Name: Brisbane Knights Football Club Inc.

BSB: 064172 Account: 1086 0694

Reference: Your Surname & "SKILL"

ANY ENQUIRIES: admin@brisbaneknightsfc.com.au

PHONE: Eric 0448 558 281 or Roy 0428 718 556
ESSENTIAL THINGS TO BRING

DRINK BOTTLE

SOCCER BOOTS & SHIN PADS

TOWEL

HAT

SNACKS FOR FUEL (WE WILL SUPPLY ASWELL)
eSignature: Guardian / Parent
IF USING ON LINE FORM - PLEASE PAY ON RECEIPT OF INVOICE
TERMS & CONDITIONS

*Signing this form and accepting to pay, you acknowledge that all the information provided is done correctly and in full and that you agree to the terms & conditions associated.

*This form is acknowledgement to waive your rights to litigate against the Brisbane Knights Football Club Inc and Croatian Community Centre (QLD) Limited for any personal injury that occurs whilst on premises.

*Information gathered is done so in accordance with the Privacy Policy. If you require the Privacy Policy please contact us at admin@brisbaneknightsfc.com..au

* Children outside the age group will be considered with consultation.

* Cancellation fee applies.

* Program is from 330PM - 630PM, staff will be present from 230PM to 700PM.

* The Croatian Club restaurant will be open from 6PM.
Should be Empty:

Brisbane Knights Juniors Holidays Skill Clinic Registration Friday 1st October 330-630pm

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