Get Active Kids Victoria

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* 1. Parent Email

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* 2. Participant Full Name

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* 3. Voucher Code

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* 4. Voucher Amount

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* 5. Centre Name

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* 6. MyGolf Program Name.

PLEASE NOTE: This needs to be the exact program name

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* 7. MyGolf Program Amount

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* 8. MyGolf Program Start Date

Date / Time

Date

Time

AM/PM