Vector Health

Netball Performance Program Term 4

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Athlete/Client 1

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Athlete/Client Details

Athlete/Client First Name

Athlete/Client Last Name

Date of Birth

Gender

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Email Address

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Home Phone

Mobile/Cell

Parent/Guardian Details

Mother's Name

Mother's Email Address

Mother's Mobile/Cell

Father's Name

Father's Email Address

Father's Mobile/Cell

Address

Address 1

Address 2

Suburb/Town

State/Prov

Zip/Postcode

Health and Fitness

Do you have any injury concerns?

Do you have any medical conditions?

Sport (if applicable)

How did you hear about us?

Dates

From 04-Oct-2016 to 09-Dec-2016

Days & Times

Once a time slot is full you will be asked to make another choice.

Time	Tue	Wed
6:30 - 7:30 am		Strength and Conditioning Personal Coaching Session athletes from 14 and up Vector Health - 102 William St Rockhampton
5:30 - 6:30 pm	Strength and Conditioning Personal Coaching Session - athletes from 14yrs and up Vector Health - 102 William Street	Junior Netball Development Session - Strength, Power, Mobility and Core Strength - Under 14yrs Vector Health - 102 William St Rockhampton

DISCLAIMER:
I hereby agree to assume all risks and responsibilities surrounding my (or my child's) participation in the program under the instruction of Vector Health coaches. I understand that similar to all sporting activities, there is a risk of damage to personal property, injury or death which may result from causes beyond the control of, and without fault or negligence of Vector Health, its officers, agents, or employees, during the period of my (or my child's) participation. I understand completely the above agreement and agree to be bound thereby. By registering on our site you agree that we may send you email related to our facilities and programs. We will not provide your details to any other company.

Agreement

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Signed

Date

19-May-2024

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