UNITED PLUS+ FOCUS SESSIONS

UNITED PLUS+ FOCUS SESSIONS

Please complete the registration form below and submit payment to details below to confirm your position in our Focus Small Group or Individual Sessions.
Payment & Confirmation Details

Account Name - Gold Coast United LTD / Account Number - 230769606 / BSB - 633000 (Reference - Child's surname and age group + Session Preference . E.g. Walker U10 4-Player Group)
Players Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Current Club*
E.g. U15
Current Team*
E.g. U15
2026 Age Group*

U9U10U11U12U13U14U15U16
Coach Preference*

Jamie DixonMatt JenningsGreg AmaralKeelan O'Connell
Session Preference*

Focus Small Group - 4 Players ($300 for 6 Weeks - $50 Per Session)Focus Small Group - 6 Players ($240 for 6 Weeks - $40 Per Session)Focus Individual Session - 1on1 ($600 for 6 weeks - $100 Per Session)
Additional Notes*
Please make any additional notes on; Location Preference, Before or After School Preference, and name any players your child wishes to be grouped with if any.
Parent / Guardian Name*

First NameLast Name
Parent / Guardian Email*
example@example.com
Parent / Guardian Mobile*
Please enter a valid phone number.
Should be Empty:

Payment & Confirmation Details