East Coast Bays Rugby Registration

East Coast Bays RC4Kids Registration

April School Holidays Tuesday 7th - Wednesday 8th April 496 East Coast Road, Windsor Park, Auckland 9:00 am to 2:30 pm, with drop-off from 8:30am and pick up available until 3pm
Child Information*
Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Relationship to Child/ren*
Parent/ Guardian Email*
Please insure this email is correct as we will be contacting you with more information and what to bring.
Alternative Emergency Contact Name*

First NameLast Name
Alternative Emergency Contact Phone Number*
How did you hear of us?*

Rugby clubReturning customerFacebook advertisingFlyerWord of mouthOther

Two Day Holiday ProgramChoose the correct quantity when registering more than one child. If you wish to register your child for just one day, use the code oneday below. Please remember to add a note with what day your child will be attending.

$120.00NZD Number of Children
Item subtotal:$0.00NZD

Enter coupon

Total

$0.00NZD

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

If your child is attending for only one day of our two day program, please make a note of which day they will attend below.
Should be Empty:

East Coast Bays RC4Kids Registration

Emergency Contact Information