REGISTRATION FORM
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
Contact Number
*
Please enter a valid phone number.
Select Your Childs Squad
*
Please Select
Junior Squad
Recreation Squad
Adrenaline Squad
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Book Your Junior Classes
Junior classes are one session per week, so please only select one class.
Please Select One
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Book Your Recreation Classes
Recreation squad classes are one session or two sessions per week.
Belmont - Select One or Two Classes
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.
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.
*
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( X )
Junior Squad - One Session Per Week
$
335.00
AUD
Junior Squad - Two Sessions Per Week
$
445.00
AUD
Recreation Squad - One Session Per Week
$
335.00
AUD
Recreation Squad - Two Sessions Per Week
$
445.00
AUD
Adrenaline Squad - One Session Per Week
$
355.00
AUD
Adrenaline Squad - Two Sessions Per Week
$
475.00
AUD
Credit Card
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