Holiday Program - Sutherland Shire

School Holidays

Sutherland Shire - Buckle Reserve, Menai
Participant Full Name*

First NameLast Name
Date Of Birth*

DayMonthYear
Date
Parent Full name *
Email*
example@example.com
Mobile Number*
Emergency contact 2 - Full name*
Mobile Number*
Do you give consent for your child to be filmed for social media content?*

YesNo
Does your child suffer from any medical conditions that might affect their participation?
Payment

3 days - $1322 days $110
If your child is not attending all 3 days, please list the days your child will be attending
To make full payment, make a bank transfer to the account below.

BSB: 112-879

Account Number: 417 313 256

Account Name: MT FOOTBALL PTY LTD

Description: (Childs Full Name) & Sutherland HP
How did you hear about the MT Football Holiday Program?

Referred by a friendFacebook / InstagramReturning player
Should be Empty:

School Holidays