REGISTRATION FORM
Term 3 2026
Name of Parent
*
First Name
Last Name
Name of Child
*
First Name
Last Name
Parent Email
*
example@example.com
Date of Birth of Child
*
Day/Month/Year
Format: 00-00-0000.
Contact Number
*
Please enter a valid phone number.
Format: 0000-000-000.
Select Your Childs Squad
*
Please Select
Junior Squad
Recreation Squad
Adrenaline Squad
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Book Your Junior Classes
Junior squad classes are one session or two sessions per week.
Term 3 - Select One or Two Classes
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Book Your Recreation Classes
Recreation squad classes are one session or two sessions per week.
Term 3 Belmont - Select One or Two Classes
Term 3 Cockburn - Select One or Two Classes
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Book Your Adrenaline Classes
Adrenaline squad classes are one session or two sessions per week.
Term 3 - Select One or Two Classes
Term 3 Cockburn - Select One or Two Classes
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Youth Squad Payment
Please only select one of the payments below that is from the squad selection you have made.
Select accordingly.
*
Categories:
All
All
Junior Squad
Recreation Squad
Adrenaline Squad
Youth Squad Shirt
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( X )
Junior Squad
Junior Squad - One Session Per Week (Term 3)
$335.00 AUD
$
335.00
AUD
Junior Squad - Two Sessions Per Week (Term 3)
$445.00 AUD
$
445.00
AUD
Recreation Squad
Recreation Squad - One Session Per Week (Term 3)
$355.00 AUD
$
355.00
AUD
Recreation Squad - Two Sessions Per Week (Term 3)
$465.00 AUD
$
465.00
AUD
Adrenaline Squad
Adrenaline Squad - One Session Per Week (Term 3)
$375.00 AUD
$
375.00
AUD
Adrenaline Squad - Two Sessions Per Week (Term 3)
$485.00 AUD
$
485.00
AUD
Youth Squad Shirt
Youth Squad Shirt
$35.00 AUD
$
35.00
AUD
Size
Youth 6
Youth 8
Youth 10
Youth 12
Youth 14
Youth 16
Adult XS
Adult S
Adult M
Credit Card
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