Adult Session Weekly Membership

Adult Training

The form is for the Weekly Membership to Adult Training Sessions.
Australia State*

Adult Training

The form is for the Weekly Membership to Adult Training Sessions.
Queensland*

Adult Training

The form is for the Weekly Membership to Adult Training Sessions.
Brisbane Program*

Adult Training

The form is for the Weekly Membership to Adult Training Sessions.
You have selected Adult Training Session in
At the following location
Program*

Athlete Details
Athlete Name*

First NameLast Name
Athlete Date of Birth*

DayMonthYear
Date
Athlete Gender*
Athlete Email*

Confirmation Emailsharksvolleyball@example.com
Athlete Mobile*
Please enter a valid phone number.
Formatted Phone Number for Active Campaign
ONLY FOR BACKEND USE
Is the Athlete prescribed an inhaler? If yes, please describe instructions. Does the Athlete have any allergies, chronic illnesses, or medical conditions? If yes, please describe.*
Please upload a proof of age (Birth Certificate/Drivers Licence/Passport)*

This information is private and confidential
Cancelof

Emergency Contact Details
Emergency Contact Name*

First NameLast Name
Emergency Contact Mobile Number*
Please enter a valid phone number.
Emergency Contact Relationship*

Playing Experience
How did you hear about us?*

My Products*

Adult Training SessionAttending regularly? Register for the Adult Session Weekly Membership and only complete the form ONCE! Attend any Adult Training Session Available

$15.00AUD for each week

Enter coupon

Credit Card

The Emergency contact for the Athlete is:
Confirmations and updates will be sent to the below phone number and email address:
You are about to register {athleteName} for {youHave} Adult Sessions at {atThe}
This is the correct session and I am happy to proceed*

YesNo
Disclaimer

To submit your registration, please read and agree to the following Policies and Procedures and Medical Release Authorisation.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature*

Clear
To submit registration, please agree to the following*

I have read and agreed to Sharks Volleyball's "Terms and Conditions"I have read and agreed to Sharks Volleyball's "Medical Release Authorisation"I have read and agreed to Sharks Volleyball's "Adult Session Terms and Conditions"I am over the age of 18 years old
To view our "Terms and Conditions" and "Medical Release Authorisation", please visit our website www.sharksvolleyball.com/policies

To view our "Adult Session Terms and Conditions", please visit our website and scroll to the bottom of the page www.sharksvolleyball.com/adult-session
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Adult Training

Adult Training

Adult Training

Adult Training

Athlete Details

Emergency Contact Details

Credit Card

Disclaimer