Hockey ACT Australian Players Clinic

Hockey ACT Australian Players Clinic

February 17th, 12pm - 2pm, National Hockey Centre, Lyneham Contact Hockey ACT on 02 6189 0570 or email Brendan.Hardman@hockeyact.org.au
Clinic Cost:

$50 first participant
2nd and 3rd Family member $20 each
Family of 4 or more $90

Hockey ACT Bank Details

Bank: ANZ
BSB: 012-955
Acc.No.: 4596 18074

Please reference payment with AusPClinic

Payable via. eftpos on the day or through direct debit
Name*

First NameLast Name
Email (Must be of Parent or Guardian if U18)*
example@example.com
Email 2
example@example.com
Phone Number*

Area CodePhone Number
How old is the participant?*
Which club are you affiliated with?
Should be Empty: