Holiday Coaching Clinic
Online Booking Form

Family Name       

                           Given Name                          Date of Birth     Level*                     School

                                    (for one or more family members)       (dd/mm/yy)      (B=Beginner)

                      1.           

                      2.           

                      3.           

                      4.           

  * For level,  please indicate by "B" if the student is a beginner (i.e. does not yet know the moves).

 Parent's name    

 Email address  

 Phone number 

           Email address (or phone number) is required for confirmation of booking.

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 For new students (or students whose address has changed –  please leave blank otherwise):

      Address       Street    

                           Suburb           Postcode        

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 Comments/questions (optional):

 After submitting your booking you will be shown the details you      

 have sent (you may print this if desired). You may then exit (or

 return to the form). You will later receive a confirmation by email

 (if the email address you have supplied is correct – please check it!)

 When you receive confirmation of your booking please complete the entry form

 (in the magazine or downloaded and printed from the website) and post it with

 payment (cheque or money order) to the address on the form.