Somersfield Training Program Term 2 January 6th to March 19th
In Partnership with LBFA
Students Name
*
First Name
Last Name
Players DOB
*
-
Month
-
Day
Year
Date
Students Gender
*
Male
Female
Grade Going into for January?
*
Grade
Amount of days per week they’re participating?
*
1-5 days
Need a Kit? The cost is $101.98 each kit.
*
Yes Please!
No Thanks!
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Contact No.
*
Parent/Guardian Contact No.
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact No.
*
Financial Information
Please fill out all information required.
Which term they are registering for?
*
Second
Third
Full Year
How many players you are registering?
*
1 Player
2 Players
3 Players
The Cost Per Session:
Afterschool club (1 session per week) term dates:
* Term 2: 10 weeks (9 Monday sessions) $150/$135
* Term 3: 9 weeks $135
Afterschool club (2 sessions per week) term dates:
* Term 2: 10 weeks (9 Monday sessions) $300/$270
* Term 3: 9 weeks $270
Early morning sessions:
* Term 2: $150/$225 one day, $300/$475 two days (9 mondays)
* Term 3: $150/$225 one day, $300/$475 two days
Other Information
Will the player take part in the breakfast program in the mornings? The cost is $10 each week
*
Yes Please!
No Thanks!
How would you like to settle the payment?
Bank Transfer
Card Payment
Banking Information for Direct Deposit:
Account Name: LB Peak Performance Bank: Clarien Bank Account Number: 6000248351
Submit
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