Course Registration Form

Sharks Summer Camp 2019

Please fill out the form carefully for registration. * A $10.00 one-off registration fee is payable on signing up.
Player Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Parent/Guardian Address

Street Address

Street Address Line 2

CityState

Postal CodeCountry
E-mail
Mobile Number

Area CodePhone Number
Are you a 2019 Sharks registered player?
If not, have you played rugby league before?
Does your child have an allergy or any medical issue we need to be aware of?

Summer Camp$10.00 AUD

Quantity
Item subtotal:

Total $0.00 AUD

Sharks Summer Camp 2019