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Flare Football In-Club Coaching Registration
TERM 3 2019 - 8 week program
Participant Name
*
First
Last
Date of Birth
*
DD
/
MM
/
YYYY
Junior Club
*
Emergency contact name
*
Phone
*
###
-
###
-
####
Email
*
Venue
*
Gerringong U6,U7 & U8 - $120 starts Monday 29 July 4:30pm-5:30pm
Gerringong U9, U10 & U11 $120 starts Monday 29 July 5:30pm-6:30pm
Albion Park U9 to U12 - $120 starts Wednesday 31 July 4:30pm-5:30pm
Unanderra U8 to U11- $100 starts Monday 29 July 4:30pm-5:30pm
Figtree U6 to U9 - $120 starts Friday 26 July 4:30pm-5:30pm
Figtree U10 to U13 $120 starts Friday 26 July 5:30pm-6:30pm
Fernhill U7,U8 & U9 - $120 starts Friday 26 July 4:00pm-5:00pm
Fernhill U10,U11 & U12 - $120 starts Friday 26 July 5:00pm-6:00pm
Balgownie U8 to U11 - $120 starts Monday 29 July 4:30pm-5:30pm
Registration payment (less active kids voucher if redeeming) will be made via:
*
Direct Bank Transfer: IMB BSB:641-800 ACCOUNT NO: 200744102 REF: FLARE SURNAME
Credit card via phone 02 42856929 *nb. a 2.5% credit card surcharge will apply.
Payment must be made in full within 5 working days of this registration in order to secure your child's position in the program
Active Kids Voucher Number
Child's name as per Active Kids Voucher
Additional comments
