HIGH PERFORMANCE- Term 2 Clinics
Please fill out your personal details and select the clinics you wish to attend.
Participant Full Name
*
First Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
Date
Current Club
*
Goalkeeper Clinics Available
Coomera -
Gold Coast Knights
Wynnum Wolves -
GCU -
Iona -
Redlands -
Tintenbar -
Outfield Clinics Available
Coomera -
Redlands -
Tweed -
Iona -
Tintenbar -
Please list the exact day / days you want to book (Full list is below)
*
Do you give permission for photos to be taken and used for promotional purposes?
*
Yes
No
Please list any medical conditions or allergies
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
*
example@example.com
Register
Should be Empty: