HSH+ Mentorship Rego Form
Join the HSH+ Mentorship Program (Term 3 - Term 4 2024)
Player Name
*
First Name
Last Name
Phone Number
*
Country Code- Area Code- Phone Number
Email
*
example@example.com
Date of Birth (dd/mm/yyyy)
*
Select Your Mentorship Package Type
Please Select
Semi-Privates (2-6 players)
1-on-1 Coaching
Mentorship Package (Privates + Gameplay)
Online Mentorship
Gender
*
Male
Female
Playing Level:
*
Beginner
Intermediate
Advanced
Are you a Reps player?
*
Yes
No
If "Yes", please list your Club/School/Reps team(s)
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Number
*
Country Code- Area Code- Phone Number
For COVID-safety, players over 16 years must be vaccinated. Are you vaccinated?
*
Yes
No
Select Your Training Goal(s):
*
Build Skills & Fundamentals
Challenge & Motivation
Get a Routine
Get in shape
Select Your Playing Goal(s):
*
Get playing time
Score points
Get recruited
Build confidence
How did you hear about us?
Please Select
Friend Referred Me
Heart & Soul Hoops
International Sports Camps
Social Media
My School
Other
Comment or Message
*
Submit
Should be Empty: