West Harbour School Holiday Camp
Dates:Tuesday the 6th of October & Wednesday the 7th of October

Time: 9:00am to 3:30pm

Venue: St. Luke's Oval

Price: $80 for 2 days, $60 for 1 day

Please fill out separate form for siblings

Transfer money to the following bank account (Child/s name in the reference);

West Harbour Rugby
BSB: 633 000
ACC: 175 095 355

Contact details:

Kodie Hawkins
Mobile: 0423 446 385 Email: info@riseuprugby.com

Email address *
Name of Child *
Date of Birth *
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Parent Name *
Contact Number *
Email Address *
Is your child registered at a junior rugby club? *
If yes, what club is your child registered at?
Do you give consent for your child's name and photo to be published? *
Any medical conditions or dietary requirements? *
If you answered yes to the above question - what is your child's medical condition?
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