MINI WHEELER COACHING WITH JORJA

MINI WHEELER COACHING WITH JORJA

SUNDAY 6TH JULY 2025 9AM
COST: $1O PER RIDER, PAYABLE TO THE COACH
Riders Name*

First NameLast Name
Date of Birth*

MonthDayYear
AUSCYCLING License Number*
Assisted Mini WheelerUnassisted Mini WheelerPedal Bike (just starting)
PARENT DETAILS (IF UNDER 18)
Parent Name

First NameLast Name
Parent Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent Email Address
example@example.com
Informed Consent and Acknowledgement I hereby give my approval for my child’s participation in any and all activities prepared by Hawkesbury Hornets BMX Club during the selected coaching session.

Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty: