GAMEREADY Goal Keeper Football Clinc
Registration form
Personal Information
Name
*
First Name
Last Name
Email
*
example@example.com
Age Group
*
9-12 Year Old
13-16 Year Old
Select date
*
Wednesday 23rd & Thursday 24th April (9:30am - 1:00pm)
Thursday 10th & Friday 11th July (9:30am - 1:00pm)
Thursday 9th & Friday 10th October (9:30am - 1:00pm)
Player details
*
Has any player been identified as living with a disability?
*
Yes
No
Please specify
*
Where did you hear about the program?
*
Please Select
Social Media
Email
Word of mouth
Radio
Tv adverts
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GK School Holiday Clinic
Please buy a ticket for each registered player
$
110.00
AUD
Quantity
0
1
2
3
4
GK School Holiday Clinic ***ONE DAY ONLY***
$
55.00
AUD
Quantity
0
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit registration
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