Rostrevor Aussie Hoops Registration

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Enter your details below to register your participation in the Rostrevor College Aussie Hoops program.

Individual's Details
Parents Name*
First Last
Players Name*
First Last
Gender*
- Male
- Female
- Other/Prefer Not to Say
Date of Birth*

DD
MM
YYYY
Your Phone Number*
Your Email*
Child's School*
Training Fee
Training Fee
Price:
Additional Information
Is you child attending or eligible to attend primary school (Years R-7) in 2021?*
- Yes
- No
Suburb*
Payment Information
Total
$ 0.00
Credit Card*

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Address*
City State / Province / Region ZIP / Postal Code Country
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