Kicking Class Rego Form

Sweet Kicks Kicking Class
Player Full Name*
Current Club*
Players Age*
Years Playing Footy*
Contact Mobile Number*
Contact Email Address*
Dates Attending - select option that best applies*

ALLOct 10thOct 17thOct 25thOct 31st
ICE Contact Name*
ICE Contact Phone*

Area CodePhone Number
List any injuries that may restrict your participation:

Payment:*

Kicking Class Sessions$80.00AUD

Completing 3 or 4 Sessions, will include training top.

T-Shirt

Kicking Class Casual Sessions$35.00AUD

If completing 2 or less sessions.

Quantity
Item subtotal:$0.00AUD

Total $0.00AUD

Payment Method
Credit	Express

Sweet Kicks Kicking Class