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Chippers Finishing School CUBS - July 2018
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Age: 5-7 Years (Boys and Girls)
Monday 9th- Wednesday 11th July, 2018
Holy Spirit College, Bellambi
1.00pm - 3.00pm
Please note: Cost $95 inclusive of registration fees and Chippers training shirt, orange breaks, quality coaching and special Chippers drink bottle
Payment can be made at time of registration via PAYPAL or EFT to the following Acct.
Acct. Name: Chippers Finishing
Bsb: 012593
Acc. no: 232110647
Ref. your name
Invoice will be emailed following receipt.
Please pay within 7 days to secure your spot.
All players are expected to wear training shirt and boots for the duration of the clinic. (Receive on Day 1)
Player's Name
*
First
Last
FFA Number
not compulsory
Date of birth
*
DD
/
MM
/
YYYY
Age group
*
Please select
5 years old
6 years old
7 years old
8 years old
Please tick box appropriate to your child.
Current Team
Not currently with a club
Club
Name of Club
Clothing size
*
Please select
4
6
8
10
12
Medical Declaration
Do you suffer from a medical condition that will affect your participation?
*
Please select
Yes
No
If yes please answer the following;
Medical condition; eg...Asthma, Injury, Epilepsy
Photo and Video Declaration
*
Yes
No
Players may have photos and video's published on website/media or used in future promotions
Guardian Information
Please enter parent or legal guardian information here
Name
*
First
Last
Parent / Guardian Phone (work/home)
Parent / Guardian Phone (mobile)
*
Email
*
Address
*
Street Address
City
State / Province / Region
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Country / Region
Where did you hear about us?
Facebook
Email
Parents Guide Illawarra
word of mouth
Other Social media
Attended previous clinic
Contact us
Dean Merola; chippersfinishingschool@gmail.com 0404487226
Payment to be finalised within 7 days of submitting form to guarantee your placement
Web Site
Image
Price
$
Dollars
.
Cents
Pay now by PayPal or by EFT within 7 days
Total
$95.00