Pop Up Clinic Booking Form
Heart & Soul Hoops Pop Up Clinics is taking professional coaching & training into your community. Sydney Suburbs we service: Lower North Shore, Upper North Shore, Northern Beaches, Central Sydney, Ryde, Inner West, Parramatta, Hills District, and Eastern Suburbs. Book your clinic today
Name
*
First Name
Last Name
Phone Number
*
Country Code- Area Code- Phone Number
Email
*
example@example.com
Preferred Date
*
-
Month
-
Day
Year
Date
Preferred Start Time
*
Hour Minutes
AM
PM
AM/PM Option
Preferred Location
*
Expected number of players
*
Theme
*
Please Select
Learn to Play
Sharp Shooter
Girls Club
GAME ON
Challenge Zone
High Performance
Coach Development
I am undecided
Venue type
*
School
Leisure Centre or Recreation Centre
Local Club Association
Private Property
Gender
*
Male
Female
Co-ed
Select Your Age Group(s)
*
Juniors (8-14 yrs)
Seniors (15-19 yrs)
Adult (20+ yrs)
Playing Level(s):
*
Beginner
Intermediate
Advanced
Professional
Are you a CLUB or School?
*
Yes
No
If "Yes", please list your Club or School team(s):
For COVID-safety, players over 16 years must be vaccinated. Are you vaccinated?
*
Yes
No
Select Your Training Goal(s)
Get in shape
Build skills & fundamentals
Get a routine
Challenge & motivation
Select Your Playing Goal(s)
Get playing time
Get recruited
Find a team
Build confidence & decision making
Score points
How did you hear about us?
Please Select
Friend Referred Me
Heart & Soul Hoops
International Sports Camps
Social Media
Other
Did a Coach refer you? If yes, please select your Coach's name below:
Please Select
Coach Alex
Coach Jared
Coach Xavier
Coach Arianna
Coach James
Coach Easa
Coach Jalen
Coach David
Comment or Message
*
Submit
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