Holiday Program
Wollongong - Judy Masters Park, Balgownie
Participant Full Name
*
First Name
Last Name
Date Of Birth
*
-
Day
-
Month
Year
Date
Parent Full name
*
Email
*
example@example.com
Mobile Number
*
Emergency contact 2 - Full name
*
Mobile Number
*
Does your child suffer from any medical conditions that might affect their participation?
*
Do you give consent for your child to be filmed for social media content?
*
Yes
No
Pricing Options (inc gst.)
prev
next
( X )
3 Days
$
135.00
AUD
2 Days
$
115.00
AUD
1 Day
$
75.00
AUD
Black Hat
$
16.00
AUD
White Hat
$
16.00
AUD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
If your child is not attending all 3 days, please list the days your child will be attending
How did you hear about the MT Football Holiday Program?
Referred by a friend
Facebook / Instagram
Returning player
SUBMIT
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