April School Holiday Camps

Student Name*

First NameLast Name

Student Date of Birth: *

Injury / Medial Condition:

Student Gender

MaleFemaleOther

Week 1

Monday 14thTuesday 15thThursday 17th (Round Robin)

Week 2

Tuesday 22ndWednesday 23rdThursday 24th (Round Robin)

Payment

To avoid credit card surcharges, please pay directly to:

Name: Stephen Halls
BSB: 812-170
Account: 48693

subtotal w1 hidden

subtotal w2 hidden

Payment preferences:*

Bank accountCredit card

Total Required $

Payment Amount

AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

E-mail*

example@example.com

Mobile Number*

Area CodePhone Number

Residential Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

1. All fees must be paid by Due Date. If not paid within 7 days of the due date your position will be forfeited. No exceptions unless discussed with coach.
2. Payments may be made direct to coach or on-line (details for direct deposit listed on top of page); a receipt will be issued in due course.
3. Your child will not be able to participate in the program if fees are not received by the due date.
4. No credits or refunds. Please choose your dates carefully.
5. Parents/Guardians must sign their child in on arrival and out on departure. If another parent/guardian is collecting your child/children you will need to notify staff on or before arrival.
6. Privacy Statement: Your Personal information will only be used in accordance with the Revolution Tennis.
7. Publicity Statement: Photographs and results from competitions maybe used to promote RT classes and events for publicity purposes, without compensation. Please inform us if you do not want your child’s photo published before they start classes.

Hunters Hill April Junior Development Camp

Date attending camp:

Parent/Guardian Info