Next Gen Rugby - June Rugby Coaching Clinic

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Rugby Junior Coaching Clinic 30 June, 1, 2 July
First Child's Details
Child's Full Name*

First NameLast Name
Child's Date of Birth*

DayMonthYear
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Any specific medical conditions, allergies or injuries*
Are you registering more than one child?*

YesNo
Second Child's Details
Child's Full Name*

First NameLast Name
Child's Date of Birth*

DayMonthYear
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Any specific medical conditions, allergies or injuries*
Third Child's Details (if applicable)
Child's Full Name

First NameLast Name
Child's Date of Birth

DayMonthYear
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Any specific medical conditions, allergies or injuries
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian Full Name*

First NameLast Name
Parent/Guardian E-mail*
Parent/Guardian Phone Number*
Emergency contact details*
How Did You Find Out About This Clinic?*
School Name*
Club Name*
I/we understand that photos, video and digital images could be taken during the junior coaching clinic and displayed on the website and promotional material for Next Gen Rugby Coaching. No names of children will be displayed.*

I agree
I/we authorise the nominated First aid officer to provide any medical attention required in the event of an emergency or accident. I/we understand that any expenses related to medical attention being provided to my child will be the responsibility of the parent/guardian.*

I agree
I/we have read the Wet Weather & Cancellation policy*

Yes
Please select your ticket. All prices inc GST*
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Junior Coaching Clinic - 3 Days - First Child$210.00AUD

Quantity

Junior Coaching Clinic - 3 Days - Additional Children$189.00AUD

Quantity

Junior Coaching Clinic - 2 Days - First Child$190.00AUD

Quantity

Junior Coaching Clinic - 2 Days - Additional Children$171.00AUD

Quantity

Junior Coaching Clinic - 1 Day - First Child$130.00AUD

Quantity

Junior Coaching Clinic - 1 Day - Additional Children$117.00AUD

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Total $0.00AUD
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First Child's Details

Second Child's Details

Third Child's Details (if applicable)