BUTTSBURY YEAR 5&6 GIRLS

GIRLS ONLY

FRIDAYS AFTER SCHOOL with Coach Alexandra Potter

3.20 - 4.20pm

10 Sessions -£50

NO session on Friday 3rd Mqy or Friday 24th May (Year 6 trip)

Please complete:

Log In if you created an account
Choose the Year 5&6 Girls Club
Select Continue (black button)
Enter Childs First and Last Name
Enter Phone Number
Enter Email
Select Pay Now (black button) to make a Card Payment
Select Pay Later (black button) to make an electronic payment using your online banking. (Account details below)

PLAYER DETAILS SIGN UP

Players Name

First Name

Last Name

Date of Birth

PLEASE NOTE : MONTH / DAY / YEAR

MM

DD

YYYY

Gender

School Year

Medical Conditions / Educational Needs

* by completing Medical/Educational Needs you have given consent for us to hold this information under special category data

Parent/Guardian Name

First Name

Last Name

Parent/Guardian Mobile No.

Parent/Guardian Email Address

Payment Method

Payment Date

PLEASE NOTE - Month / Day / Year

MM

DD

YYYY

FIRE BASKETBALL CIC

SORT CODE : 20-12-21

ACCOUNT : 13658619

REFERENCE : BU45g <SURNAME>