Vector Health

Contact Sport Development Program - Junior 9-13yrs - School Holiday Program December 2017

Athlete/Client 1

Athlete/Client Details

Attendee First Name

Attendee Last Name

Email Address

Confirm Email Address

Create your password

Enter the password that you would like to use for your new account.

Confirm your password

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

Sport (if applicable)

Training Dates

From 11-Dec-2017 to 15-Dec-2017

Training Days & Times

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

			Mon	Tue	Wed	Thu
3:30 pm	Speed - Agility - Fitness Session	Victoria Park - Huish Drive
4:30 pm	Strength and Conditioning Session	Vector Health 102 William St

DISCLAIMER:
This program is for young athletes wanting to improve their athletic ability in their sport. Our focus is on technique, and moving your bodyweight effectively in the gym and on the field. There are two gym based sessions and two field based sessions. Parents are welcome to stay and watch the sessions and we encourage this so you know what we are talking to your son or daughter about.

Agreement

Signed (Parent/Guardian)

Date

/ /

Payment Method

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.

Cost

$66.00

Cost Per Person

$66.00

Total Cost

Group Discount

Grand Total

PayPal (Credit Card or PayPal Account)

Credit Card (Ezidebit)

Please mail this form with a payment attached to: "Vector Health, 102 William Street , Rockhampton QLD 4700"