Athlete Development - Running Specific - Speed, Agility, Running Technique and Fitness - Term 1 - 2017

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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?
Mobile/Cell:
Address 1:
Address 2: Do you have any medical conditions?
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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
4:30 pm
Speed - Agility - Fitness Session
Victoria Park - Huish Drive - Rockhampton

DISCLAIMER:
This is a running specific program. We aim to increase your knowledge of technique and how this applies to going faster. We expect your commitment and your dedication to success. You will get homework to do as part of the program. Not much, but a little bit regularly! We look forward to helping you run faster!

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: $150.00 1 Session per week focused on technique, speed, agility and fitness specific to sport
Total Cost: $0.00
Credit Card: PayPal
  
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