Junior Athletic Development - 8-12 years - Term 1 2018 MONDAY - WEDNESDAY afternoons

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Athlete/Client 1 Details Parent/Guardian Details
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Athlete/Client First Name: Mother's Name:
Athlete/Client Last Name: Mother's Email Address:
Date of Birth: Mother's Mobile/Cell:
Gender: Male Female Father's Name:
Email Address: Father's Email Address:
Confirm Email Address: Father's Mobile/Cell:
Home Phone: Do you have any injury concerns?
Address 1:
Address 2: Do you have any medical conditions?
Sport (if applicable):
How did you hear about us?

Training Dates: From 22-Jan-2018 To 30-Mar-2018

Training Days & Times:
Once a time slot is full you will be asked to make another choice.

Time Mon Wed
3:30 pm
Athletic Development Session
Vector Health and Performance - 102 William Street
Athletic Development Session
Vector Health and Performance - 102 William Street

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.

I agree (Parent/Guardian):
Date: 18-Jan-2018
There are no refunds for any enrolments into Vector Health related programs. When you sign/tick confirmation for this enrolment you are acknowledging that you know this as a fact and have accepted it as a condition.
Payment Method:
Cost: $115.00 1 Session Per week
$222.00 2 Sessions per Week
Total Cost: $0.00
Credit Card: PayPal
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