THIS ONLINE FORM IS TO BE COMPLETED BY THE PLAYERS PARENT/GUARDIAN.

Date: Tuesday 1st October 2013 (School Holidays)
Time: Drop off at 9:00 am & pick up at 1:00pm
Venue: Nolans Reserve, North Manly
Age Groups: Boys & Girls 8-14 years - Positions are limited

COST $40 PER PARTICIPANT - MUST PAY IN FULL BEFORE THE DAY.

PAYMENT DETAILS:
Bendigo Bank Account Name: Manly Women’s Open Touch Football
BSB: 633 000 A/C: 145 671 368
Please ensure you put the players name on your transfer so it can be identified.

Further information via:
www.manlywomenstouch.com/devday2013
email@manlywomenstouch.com

Question Title

* 1. Parent/Guardian Name

Question Title

* 2. Parent/Guardian Mobile

Question Title

* 3. Parent/Guardian Email Address

Question Title

* 4. Player Name

Question Title

* 5. Player Gender

Question Title

* 6. Player Age as at 1st Oct 2013

Question Title

* 7. Player has permission to go home alone after the Development Day?

Question Title

* 8. Any Medical Conditions

Question Title

* 9. I certify that my child is in good health and is able to participate in all activities. If any attention is required or illness or injury, I give my permission for such care. I will not hold the MWTA or of any of its coaches responsible for any loss or injury occurring during any activities.

T