GAMEREADY Goalkeeper Clinic - West Beach Parks Football Centre
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 16th & Thursday 17th April (9:30am - 1:00pm)
Thursday 17th & Friday 18th July (9:30am - 1:00pm)
Thursday 2nd & Friday 3rd 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
Back
Next
My Products
*
prev
next
( X )
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
Should be Empty: