Glenwaverly Beginners

ICC KIDS Registration Form

Fill out the form carefully for registration!
Location : Games hall, Wesley college, Opposite to swimming centre Glenwaverly
Student Name*

First NameLast Name
Father or Mothers Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*
Age*
Address
Phone Number*
Parents E-mail*
example@example.com
Classes*

Saturday 2 pm - 3.30 pmSaturday 3.30 pm - 5 pm
Extra Class: Please note - Only for students attending either the 2 pm or 3.30 pm

Tuesday - 6.7.30 pm
Additional Comments - Please
Should be Empty:

ICC KIDS Registration Form