Chidlow Sandi Simons 2-day performance Clinic

Clinics & Camps

Clinic Registration

Step 1 of 3 - Information

Clinic Registration
Price: $ 0.00
Clinic Registration
Price: $ 100.00
Registration Type
Number of Days
Dates Attending
Please provide the dates you will be attending
Day 1 Attending*
Date Format: DD dash MM dash YYYY
Day 2 Attending*
Date Format: DD dash MM dash YYYY
Day 3 Attending*
Date Format: DD dash MM dash YYYY
Day 4 Attending*
Date Format: DD dash MM dash YYYY

Name
First Last
Email
Phone

How much will you be paying today?
Amount Paid Today
remaining balance due 2 weeks prior to the event date
Amount Paid Today
remaining balance due 2 weeks prior to the event date
Credit Card

Card Details

Cardholder Name
Name
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Clinic Details

Start Date	17 Apr, 2021
End Date	18 Apr, 2021
AU State	WA
Full Cost	$500
Fence Sitting	$132

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