Enrol - Australian Sports Clinics

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Enrolment Form

(Tuesday to Thursday: 9am-12.30pm at TO BE CONFIRMED)

First Name(Required)

Last Name(Required)

Your Email(Required)

Your Phone(Required)

Address(Required)

(Needed for legal and billing purposes)

Street Address City State Postcode Country

Cost is $80 per session per child. 4 sessions minimum required.

How many Children do you wish to enrol?(Required)

If more than 2, please call us.

Total

1st Childs Name(Required)

First Last

1st Childs Date of Birth (DD-MM-YYYY)(Required)

1st Childs Experience(Required)

Starting Out

Improving

1st Child - Medical Conditions

Any medical conditions we should be aware of?

2nd Childs Name(Required)

First Last

2nd Childs Date of Birth (DD-MM-YYYY)(Required)

2nd Childs Experience(Required)

Starting Out

Improving

2nd Child - Medical Conditions

Any medical conditions we should be aware of?

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Total

Credit Card(Required)

One 45 minute session
once a week for four weeks