Otago Nuggets Junior Baller's Clinic - School Holidays: 22-24 April

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Please complete a separate online form for each registration.

Venue: Edgar Centre, Dunedin

Dates:

Monday 22 April

Tuesday 23 April

Wednesday 24 April

Ages:

Years 4-8 only

Time/Cost

12noon to 1.30pm - Years 4-6 : Cost $25.00 per child per day

1.30pm to 3.00pm - Years 7-8 : Cost $25.00 per child per day

Bank Account Name: Sports Entertainment Network NZ Limited

Bank: ASB Bank
Account Number: 12-3107-0082919-00
**please ensure you put "April Clinic" and your child's name as a reference on your deposit.

Email *

Child's Full Name *

Parent/Caregivers Full Name *

Parent/Caregiver's Phone Number *

School Year / Age Group *

Year 4

Year 5

Year 6

Year 7

Year 8

Emergency contact name and phone number *

Select which camp dates attending: *

Monday 22 April 12noon-1.30pm: Years 4-6

Monday 22 April 1.30pm-3.00pm: Years 7-8

Tuesday 23 April 12noon-1.30pm: Years 4-6

Tuesday 23 April 1.30pm-3.00pm: Years 7-8

Wednesday 24 April 12noon-1.30pm: Years 4-6

Wednesday 24 April 1.30pm-3.00pm: Years 7-8

Required

I give permission for my child's photo / video's to be used for our promotional purposes. (Note: no children's names will be mentioned on any of our social media platforms when sharing any photo / video's taken at the camp) *

Yes

Does your child have any medical issues we should know about? *

Yes

Further Comments

A copy of your responses will be emailed to the address you provided.

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