BVB Clinic Registration Form - Club Marconi : Club Marconi

BVB Clinic Registration Form

Full Name^*

Email Address^*

Gender^*

Date of Birth^*

Age in 2020^*

Address^*

FFA Number

Current Club^*

Current School^*

Uniform Size^*

XS (YOUTH)	S (YOUTH)	M (YOUTH)	L (YOUTH)	XL (YOUTH)	S (ADULT)	M (ADULT)
CHEST (cm)
38	40.5	44	47.5	51	53	57
LENGTH (cm)
50	53	58	63	68	72	74.5

Player Position^*

Current Academy

Medical Conditions^*

XS (YOUTH)	S (YOUTH)	M (YOUTH)	L (YOUTH)	XL (YOUTH)	S (ADULT)	M (ADULT)
CHEST (cm)
38	40.5	44	47.5	51	53	57
LENGTH (cm)
50	53	58	63	68	72	74.5

Parent Name^*

Mobile Number^*

Sponsorship Interests

How did you hear about the clinic?^*

EARLY BIRD PRICES
Juniors: $295 | SAP: $395 | Youth: $395
Early bird offer ends 1 March

*No refunds