APPLICATION FORM

Coaching Camp For Young Cricketers

  

January 2010 CAMP DATES


Advanced 14 - 17 yrs    $350
2:30pm Sunday 10th  Jan  until
5:30pm Tuesday  12th Jan.

Intermediate 10 - 14 yrs  $350
2:30pm Wednesday  13th Jan until
5:30pm Friday  15th Jan.

Price includes 2 and a half days with top qualified accredited coaching, video analysis, plus on-site accommodation, net practice and turf wicket matches. All meals are supplied. Optional but recommended  DVD $25.

 

 

To secure your spot, please print out and complete the form below and return with a deposit of $80 or total by cheque or credit card to Hume and Hovell Cricket Ground, 7 Hanna’s Rd, Strath Creek, Vic, 3658. The balance to be paid prior to the commencement of the camp. We look forward to seeing you!  Optional but recommended DVD $25.
$350

Camp Type: (circle)

Intermediate    or  Advanced

 

    

Surname

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Given names

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Address

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Telephone Home

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Work

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Email

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DOB

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Credit Card No

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Expiry

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Credit Card Type:
Visa Mastercard Amex Other

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T-Shirt Size (circle) – Men's S  M  L  XL  XXL

                              Boy's 8  10  12  14  

Playing Experience

School

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Club

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District

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Batsman (circle)
Left hand
Right Hand
Top order
Middle order
Lower order
Wicket keeper
Bowler (circle)
Right arm
Left arm
Fast
Medium
Offspin
Legspin

Special medical conditions our staff should be aware of:
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I authorise the Camp Co-Ordinator, Head Coaches or their delegates to arrange medical treatment as required during the camp. Parents Guardians will be notified accordingly.
Signed

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Parent/Guardian
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Parents Christian and Surnames_________________________________________________________________