Stellenbosch Goalie School - 1st term, 2023
Please complete the following information to register for the 1st term GK sessions

DATES: 24, 31 JAN 7, 14, 21, 28 FEB 7 MAR
TIME: 18:00 - 19:00
VENUE: RHENISH GIRLS HIGH ASTROTURF
COST: R1400

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Goalkeepers details
Name *
Surname *
Age *
School/ Club *
Parent or guardian's Name and Surname *
Parent or guardian's details
Contact number *
Email address *
Comments or Questions
INDEMNITY
Therefore I hereby -

Acknowledge that I have familiarized myself with the nature and extent of the Sport and the risks and dangers to which I may be exposed as a result of my participation in the Sport;

Voluntarily assume the risks and dangers to which I may be exposed as a result of my participation in the Sport;

Indemnify and keep indemnified that Jacques Le Roux Hockey and/or its employees and/or agents against all injury, loss, damage, costs and/or expenses which I and/or any other person may sustain or incur as a result of my participation in the Sport; and

Agree not to hold the Jacques Le Roux Hockey and/or its employees and/or agents liable for any injury, loss, damage, costs and/or expenses, which I may sustain or incur as a result of my participation in the Sport.

Agree to make payment before the start of the goalie school.
*
Payment options *
Banking details

Please use your NAME & SURNAME as reference when making payment.

J Le Roux
Capitec Stellenbosch
Branch code: 470010
Savings account
Account number: 124 0300 105

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