REGISTRATION – 5 Star Sport

"*" indicates required fields

Please select which 5Star Sport camp you would like your child to attend*

Participant's name*

Date of birth*

Current School*

Parent or Guardian's name*

Address

Emergency contact phone number*

Email*

Medical conditions affecting participation / medication taken including any dietary requirements (please leave blank if not applicable)

Doctor's name*

Doctor's Address

Doctor's phone number*

Where did you hear about us?

Total

Credit Card

Card Details

Cardholder Name