WPX Experience Camps

Wellington Phoenix Experience Camps

Please complete the following form to register your child/children for the Wellington Phoenix Experience Camps
Price

For two full days (9.00-15.00) $195 per child
Locations

Monday 3rd & Tuesday 4th October - Becroft Park, North Shore (Registrations are now closed for this Experience Camp)

Thursday 6th & Friday 7th October - Soldiers Memorial Park, Greytown

(Registrations are now closed for this Experience Camp)

Friday 14th & Saturday 15th October - Tulett Park, Christchurch

(Registrations are now closed for this Experience Camp)

Monday 19th & Tuesday 20th December - Jack Reid Park, Arrowtown
Child Info
Name*

First NameLast Name
Date of Birth (Children must be born between 2008-2013)*
Gender*

MaleFemalePrefer not to say
Football Club
Does your child have any medical conditions that we should know about? Please specify any relevant medications that they may bring with them. (Please write 'nil' if none apply) *
Parent/Guardian Details
Your Name*

First NameLast Name
Email*
example@example.com
Mobile Phone Number*

PrefixPhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which WPX Experience Camp would you like to register your child for?*

Monday 19th & Tuesday 20th December - Jack Reid Park, Arrowtown
Emergency Contact (if different from above)
Name and contact number
Any additional information you think we should know.
Is your child a Goalkeeper?*

YesNo
I give permission for the Experience Camp staff to take photos of my child that may be used on Wellington Phoenix social media*

YesNo
I wish to receive communications from the Wellington Phoenix*

YesNo
Payment

An invoice will be sent to the email address provided. Payment in full is expected before the camp begins.
By signing below, I agree not to bring any claim or proceeding against Wellington Phoenix, their sponsors, their employees and volunteers of the event for any damage, loss, injury or liability you or your child may suffer from participating from the event, within reason.

I consent to my child participating in this Holiday Programme.
Signature*

Clear
Date

MonthDayYear
Date
Any queries, please contact Jesse Rawlings at jesser@phoenixacademy.co.nz
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Wellington Phoenix Experience Camps