Fast Break Friday Night Comp Entry

Dates: Friday 19th June till Friday 18th September 2015 (12 weeks)

Location: St Patrick’s College, Francis St Strathfield NSW 2135 ( School indoor basketball court )

Ages: U/l 2’s (Any child turning 11 or younger in 2015), U/l 4’s (Any child turning 12 or 13 in 2015)

Time: TBC

Cost: $150 (Attendees receive an NI DP reversible singlet which must be worn each week for the games. No singlet no play). All levels welcome.

Attendee Details

Child 1

Child 1 Name: (required)

Child 1 DOB: (required)

Child 1 Age: (required)

Child 1 School: (required)

Child 1 Year: (required)

Child 1 Shirt Size: (required)

Child 2

Child 2 Name:

Child 2 DOB:

Child 2 Age:

Child 2 School:

Child 2 Year:

Child 2 Shirt Size:

Child 3

Child Name:

Child 3 DOB:

Child 3 Age:

Child 3 School:

Child 3 Year:

Child 3 Shirt Size:

Parent / Guardian Details

Full Name: (required)

Email: (required)

Home Phone:

Mobile: (required)

Home Address: (required)

Suburb: (required)

State: (required)

Postcode: (required)

Does your child suffer from any medical, physical or emotional condition that we should be aware of?

I approve of this enrolment and understand that the organizers will take all reasonable care to ensure the well being of my child/children during the course of the camp. I will not hold them responsible for any injuries that occur during the camp. I give my consent for any necessary medical treatment and agree to meet any and all expenses incurred. I authorize that any photographic or video images taken at the camp may be used for promotional use. I understand that if my child’s behaviour is inappropriate, I may be asked to pick him/her up.