HOLIDAY SKILLS CLINIC

Name

This address will receive a confirmation email

Clinic Attending

Year at School:

Name of School:

Parent / Guardian's Name:

Parent / Guardian's Phone:

Emergency Contact (if different from above)

Address

Any food allergies or medical conditions we need to be aware of:

I give permission for my photo to be used for Lions basketball club marketing:

Terms & Conditions: Cancellations of registrations will incur a $5 administration charge. Any cancellations within 2 weeks of clinic must be advised in writing and will also be charged up to full cost of clinic if your space cannot be filled.

Yes, I accept

Payment $55.00

Description

3rd & 4th October 2019

Please complete a separate registration form for each child.
Email confirmation will be sent 1 week prior to the event.
Payment of $55 (for the 2 days) must be made to complete registration.

HOLIDAY SKILLS CLINIC

Description

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