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BOOKING FORM 2016

 

NAME OF PARTICIPANT (in full):

 

BEGINNER OR REFRESHER:

 

NAME OF PARENT/GUARDIAN:

 

Stick It 2016:

 

 
TOP CLASS SPORT CAMPS/COURSES ATTENDED IN 2015:
Shooting & Goalkeeping Double Team
No Boundaries Inside Out
Lacrosse Academy    
Stick It    

 

 

ADDRESS Line 1:

 

ADDRESS Line 2:

 

POSTCODE:

 

LANDLINE PHONE NUMBER:

 
MOBILE PHONE NUMBER:
 

E-MAIL:

 

AGE:

 

DATE OF BIRTH:

   
 

SCHOOL/CLUB:

 

SCHOOL YEAR ON SEPTEMBER 2015:

 

LEVEL OF PLAY THIS YEAR:

 

PLAYING POSITION (Lacrosse only):

 

MEDICAL:
Please use the box below to provide any necessary details about your daughter’s medical condition:

 

Please confirm that you have read and recorded, if necessary, any medical conditions your daughter:.

 
   

LACROSSE T-SHIRT:

Free to campers booked before 21 July

Bookings made after this date cannot be guaranteed a t-shirt

   

LACROSSE HOODED SWEATSHIRT:
Cost: £25 - add to final payment

   

PAYMENT METHOD:

>
   

AMOUNT:
(Total amount to include optional Hooded Sweatshirt - £25)

 
HOW DID YOU HEAR ABOUT US?
Club Email
Lacrosse Teacher Leaflet
Recommendation School
Search Engine Other
 

CONSENT:
I have read the Terms and Conditions of Top Class Sport Ltd
and agree to abide by them:

 

ANTI-SPAM CHECK: What is 10 + 4 = ?

 
 

Click on the logo below to find out how to pay

 

Top Class Sport Lacrosse Logo

 

 

 

 

Hettersley Lacrosse