Camp Application 2011

Tue, 03/08/2010 - 19:54 — renae

13's and 14's 2011 Pre Season Camp to Bickley Recreation Camp Application Form. Please complete all areas of the form and check within 24 hours to make sure your name is on the participation list.

Players Surname: *

Players Firstname: *

Age Group in 2011:

Contact Details

Address:: *

Suburb: *

Email Address to receive information:

Home phone::

Parents mobile::

Other emergency name and number:

Emergency contact relationship to you?:

Person other than the mobile number provided previously who could also be contacted in case of emergency.

Alergies

Do you have any allergies, taking any medication, or have any other medical disorder we should be aware of ?: *

Yes

If yes please provide details::

Swimming Details

Please advise your swimming ability: *

Swimming level reached:

I agree to abide by the rules of the club: : *

Yes

Email address:

Major Sponsors

BJFC Menu

Season 2012

Previous Seasons Archive

Kalgoorlie Trip Details

Camp Application 2011

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Major Sponsors

BJFC Menu

Season 2012

Previous Seasons Archive

Kalgoorlie Trip Details

Camp Application 2011