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School Holiday Clinic Registration Form
Please complete and submit the following form to express your interest in joining the Cooks River Titans School Holiday Clinic for players aged between 5 and 13 years old
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* Indicates required question
Player's First Name
*
Your answer
Player's Surname
*
Your answer
Player's Date of Birth
*
MM
/
DD
/
YYYY
Parent/Guardian Full Name (First Name & Surname)
*
Your answer
Address
*
Your answer
Suburb
*
Your answer
Postcode
*
Your answer
Contact Phone Number
*
Your answer
Contact Email Address
*
Your answer
Which day(s) will your child be attending?
*
You can select more than one option
Monday 30th September, 2024
Tuesday 1st October, 2024
Wednesday 2nd October, 2024
Required
How did you find out about the Clinic?
*
Direct email from the Club
Flyer received at school
Word of mouth
Social Media (Facebook, Instagram, Twitter, etc)
Club Website
Other:
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