WABSSA Clinic Registration Form
Name *
Your answer
Email *
Your answer
Phone number *
Your answer
Club Affiliation *
Club Name if not above
Your answer
Clinic Level *
Would you like to complete Exams to gain a Levels
** While Membership is not required we ask that you read below and tick the box for your understanding. **

Membership for WABSSA for the 2017-18 season is $20.00, CABS Membership $10.00 extra (this does not include $5 exam fee which is to be paid at time of sitting exam).
This can be paid via cheque, case or EFT to: WABSSA
Bank Account Details: BSB: 036-067 Account Number: 171 298
(please use SURNAME as reference)

I understand there is a fee of $5 to sit an exam plus membership costs (WABSA + CABS - see above for costs) *
Please invoice me
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