Competition Entry Form – Flipz Academy – Super Performance Centre

Athlete Name *

First

Last

Athlete Level *

Athlete Birthdate *

Parent/Guardian Contact E-mail *

Parent/Guardian Phone *

Competition Name

Competition Venue

Competition Date

Would you like to add Level test? *

Level test fee applies

By signing this, I understand that after purchase, competition entry fee is partly refundable ONLY with medical certificate presented to SPC *

Signature *

Competition Entry Fee (AUD)

Price: $ 5.00

$75 credit applied

Individual TRP - U13

Price: $ 21.00

Second apparatus

Total Amount

$ 0.00

Choose method of payment *

Payer Name *

First

Last

Payer Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Credit Card *

Card

Name on Card