EmailMe Form - Wollongong Wolves Autumn GK Clinic

Players Name *

First Last

Email *

Phone *

### - ### - ####

Please enter your Active Kids Voucher Number, if you have one you wish to use.

Parents/Guardian's Name *

First Last

Players FFA Number

Address *

Street Address City State / Province / Region Postal / Zip Code

Players Date of Birth *

DD / MM / YYYY

OPTIONAL

PURCHASE SHIRT, SHORTS AND SOCKS AT DISCOUNTED RATE $50

If you would like to purchase a training shirt (short sleeve), please select a size. ($30 shirt only)

Optional Purchase

- Please select your short size - Shorts - $15

Optional Purchase

- Please select your sock size - Socks - $15

Current team that they play for?

Message (Optional)