U12 Competition Registration

Commencing: Sunday 1st November 2015 to 22nd November - FOUR WEEKS

12.00-2.00pm  Albany Creek Leisure Centre, Explorer Drive, Albany Creek.

Boys & Girls born 2004 and younger who are NOT playing in the U13 Saturday Competition.  Enter a team of 6 or more or nominate as an individual.  Experienced coaches will provide a skills session each week followed by a game. 

Cost is $65 per player, including registration and insurance, and pool entry for players and spectators.

REGISTRATION FORM

Player Name
Date of Birth
Format: DD / MM / YYYY
 /  /
Gender
   
Have you played Flippa Ball or Water Polo before?

If so where?

Have you registered with another waterpolo club for the 14/15 season?

If so which club?

Email Address
Emergency contact mobile no
Emergency contact name
Please choose one of the following


Name of Team

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.

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

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