U12 Registration

Commencing: Sunday 14th August 2016 to 28th August - 5 WEEKS

2.30 - 4.00pm Albany Creek Leisure Centre, Explorer Drive, Albany Creek.

Boys & Girls born 2002 and younger. Experienced coaches will provide a skills session each week followed by game play.

Cost is $70 per player, including registration and insurance, and pool entry for players and spectators.

REGISTRATION FORM

Player Name

Date of BirthFormat: DD / MM / YYYY

/ /

Gender

Male Female

Have you played Flippa Ball or Water Polo before?

Yes No

If so where?

Email Address

Emergency contact mobile no

Emergency contact name

PLEASE NOTE: Payment MUST BE MADE with registration to ensure confirmation. Also, please note there are no part payments or refunds for sessions not attended.

NORTH BRISBANE WATER POLO CLUB INC.
BSB: 124-001
ACCOUNT: 10401503
Reference: (SURNAME)U12

If you do not have access to internet banking, you can make a deposit at any Bank of Queensland branch using the above deposit details. Thank you.

I confirm that I have made payment for this player via direct bank deposit

Any queries, please contact Jane at u12@polobears.com.au

SIGN UP TO OUR NEWSLETTER

Be the first to know about our latest promos and services