Dragons Pre School April 2023 Registration Form

MACQUARIE DRAGONS FC

COERVER PRE SCHOOL REGISTRATION FORM
Registration Form - April 2023 Session

Program starts 4 April 2023 at Waterloo Park, Waterloo Rd Marsfield at 4:30pm
Childs Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Child's Date of Birth*

DayMonthYear
Date
Child's Age*
Parent's Name*

First NameLast Name
Parent's Email*
example@example.com
Parent's Phone Number*
Please enter a valid phone number.Format: 0000-000000.
Active Kids Voucher Number - Coerver Academy will process these directly
Size 4Size 6
YesNo
Please make payment of $160.00 to complete your child's registration.

Bank: ANZ

Name: Macquarie Dragons FC

BSB: 012-327

Acct: 938-434-248
Should be Empty:

MACQUARIE DRAGONS FC