REGISTRATION FORM

Holiday Program: Term 1, 2025

Parent first name

Parent surname

Email

Telephone

Child first name

Child surname

Date of Birth of Child

Age of child

Preferred Date

Monday 14 April (no Aerial)

Monday 21 April

Wednesday 16 April

Friday 25 April

Payment

$25 per Class

$40 to include Climbing

Payment MUST be processed at Registration.

Please see account details below for transfer of funds, or contact Mandurah Indoor Rock Climbing on 9581 7465 to finalise payment.

Westpac Banking Corporation

Mandurah Indoor Rock Climbing

BSB: 036 157 ACC: 591 384

Please include your 'Surname' and 'Hols' as the reference.

Additional Information