*For Fewer Day Registrations Please Email northernbeaches@braziliansoccerschools.com Please fill out this registration form, submit details and then you will be directed to an online payment option. You can pay with a PayPal balance or credit card. YOU DO NOT REQUIRE A PAYPAL ACCOUNT TO MAKE A CREDIT CARD PAYMENT!

Choose Your Holiday Camp Venue & Dates * Select an option:Calabria Club SEPT 30-OCT 4, 5 HALF DAYS ($225 AUD)Calabria Club SEPT 30-OCT 4, 5 FULL DAYS ($300 AUD) Pittwater RSL SEPT 30-OCT 4, 5 HALF DAYS ($225 AUD)Pittwater RSL SEPT 30-OCT 4, 5 FULL DAYS ($300 AUD) Calabria Club OCT 8-11, 4 HALF DAYS ($175 AUD)Calabria Club OCT 8-11, 4 FULL DAYS ($245 AUD) Soccer5s SEPT OCT 2-4, 3 HALF DAYS ($135 AUD)Soccer5s SEPT OCT 2-4, 3 FULL DAYS ($195 AUD) Soccer5s OCT 9-11, 3 HALF DAYS ($135 AUD)Soccer5s OCT 9-11, 3 FULL DAYS ($195 AUD) Gateshead Springloaded OCT 8-11, 4 HALF DAYS ($175 AUD)Gateshead Springloaded OCT 8-11, 4 FULL DAYS ($245 AUD) Child's clothing size * Select an option:I already own a BSS uniform ($0.00 AUD)5-6 years ($50.00 AUD)7-8 years ($50.00 AUD)9-10 years ($50.00 AUD)11-12 years ($50.00 AUD)13-14 years ($50.00 AUD)14+ years ($50.00 AUD) Child's Full Name * Date of Birth *

Gender *

Male Female

Parent Full Name * Phone * Additional Phone Number * Email * Suburb * Child's School or Soccer Club * Postcode * How did you hear about our programs * Postal Address * I wish to be contacted about future Brazilian Soccer Schools programs * I give consent for my child to be photographed during the course of this program. I understand the images may be used in marketing. * Any Known Medical Conditions *

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