Registration Form
By filling in this form you are registering for the 2018 Goalie Camp from 25-27 May at Forest Hill
Email address *
Name and Surname of Goalie Attending the Camp *
Your answer
Name and Surname of Parent/Guardian
Your answer
Date of Birth (Goalie) *
MM
/
DD
/
YYYY
Email address (This is where you will receive information and updates) *
Your answer
Cellphone Number *
Your answer
Province in which you play *
Your answer
Club in which you play
Your answer
Medical Aid Provider
Your answer
Medical Aid membership number
Your answer
How long have you been playing goalie for? *
Would you like us to contact you about purchasing a camp jersey? *
I acknowledge that the cost of the camp is R1000 per goalie and hereby register the above player to attend. *
A copy of your responses will be emailed to the address you provided.
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