Student Details

First Name *

Last Name *

Date of birth *

Age *

Address

Street Address

City

State

Country

Postal Code

Parent / Guardian

Parent/ Guardian Name *

Phone *

Email *

Emergency Contact Name *

Emergency Contact Phone *

Important Information

Fees: $80 / 4 weeks | Uniform $75 | Joining $50 | Annual $65

Direct Debit Only – setup link will be emailed after form submission

Closed on public holidays | Open during school holidays

MINIMUM CONTRACT TERM: 3 MONTHS

Insurance & Liability Students must have personal insurance. Club not responsible for injuries.

Signature

Date