Single Day School Holiday Clinic April 19th- West Beach Parks Football Centre
Registration form
Personal Information
Person Responsible for the Team
Name
*
First Name
Last Name
Email
*
example@example.com
Age Group
*
5-9 Year Old
Player details
*
Has any player been identified as living with a disability?
*
Yes
No
Please specify
*
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My Products - TIME 9.30am to 1.30pm April 19th
*
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DATE SELECTION - School Holiday 5-9
Please buy a ticket for each registered player per date
$
50.00
AUD
Quantity
Price
April 19
1
2
3
4
$
50.00
AUD
Item subtotal:
$
0.00
AUD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit registration
Should be Empty: