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Details

School Ambassador Program

Date TBA

Perth Hockey Stadium, Perth Hockey Stadium, Hayman Road, Bentley, 6102

Are you attending this event?

Yes No

First name*

Last name*

Phone number*

Email address*

Address*

School Name*

Primary School or Secondary School*

What is your role within School*

School Address*

Secondary Point of Contact Name

Secondary Point of Contact Email

T-shirt Size*

Club Association (if any)

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*

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