Wicklow Athletics Hub Summer Camp Registration Form
Contact: Vicky: 087-1741064
Choose a camp date
6th July
13th July
Childs Name
*
First Name
Last Name
Date of birth
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Address
*
Address
Address Line 2
Town
County
Eircode
Phone Number
*
Format: (000) 000-0000.
E-mail
example@example.com
Does your child have any special considerations we should be aware of? Ie. Behavioural, medical conditions, injuries etc.
*
If yes please give details below
Do you give permission for your child's photograph to be taken for promotional purposes only (Instagram, Facebook)
*
Yes
No
Submit
Should be Empty: