BEACH TRIBES

BEACHVOLLEY ACADEMY

REGISTRATION & PAYMENT FORM 2022/23

(U19)

UWCSEA Dover Campus

(UWCSEA and non-UWCSEA students)

Parent / Guardian's Details

Parent/Guardian Full Name:*

First NameLast Name

Parent Email:*

Parents Contact Number:*

Please provide a mobile number

Secondary Phone Number:

Please provide a second number for emergencies

Programme Selection:

Season Details

Beach Tribes is running its program over 4 seasons, with breaks based on UWCSEA Holidays.

Season 1 - Mon 29 Aug to Sun 13 Nov 2022 (9 weeks)

Season 2 - Mon 14 Nov 2022 to 12 Feb 2023 (9 weeks)

Season 3 - Mon 13 Feb to Sun 23 Apr 2023 (8 weeks)

Season 4 - Mon 24 Apr to 18 Jun 2023 (8 weeks)

The season cost is based on a per session* cost (incl of GST):

- $35 per session

Age

Under 19 yo (Grade 11-12)

Level*

BeginnerIntermediate/Advance

Which Season do you want to join?*

Season 3Season 4

Please select the class(es) you want to take (up to 3)*

Wednesday 3:10pm - 4:25pm (Beginner)Wednesday 4:30pm - 6pm (Intermediate/Advance)Friday 3:10pm - 4:25pm (Beginner)Friday 4:30pm - 6pm (Intermediate/Advance)Sunday 8:45am - 10am (Beginner/Advance)Sunday 10am - 11:15am (Intermediate/Advance)Other

Session Cost

Total Season Cost:

Child - Details

Child's Picture

Browse Files

Please provide a recent passport style photo of your child if possible.

Child's Full Name*

First NameLast Name

Student Email:

example@example.com (optional)

Child's Date of Birth*

DayMonthYear

Child's Gender*

MaleFemale

School*

UWCSEA DoverUWCSEA EastOther school

if other school, which one?

UWCSEA Class/Adviser/Mentor Group

For UWCSEA Students please provide your grade and class/mentor/advisor initials, eg: 4ABc

Medical history or medical conditions of my child the coaches should be aware of

I have adequate Personal Accident Coverage for my child: (Please note that UWCSEA do not provide personal accident coverage for your child)*

YesNo

Payment Details

Total Cost

discount code

Please enter your discount code if you have one.

Total Cost Payable after Discount

BEACH TRIBES Total Cost*

SGDBeachvolley Payment

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

When you click "Submit" your credit card will immediately be charged the cost shown above via our secure payment gateway. You will receive an email confirmation of the form submission, followed shortly by an emailed receipt.