Shane
021 622 101
Programmes
Our approach
Enrolment
Enrolment

Parents/guardians can complete the form below to register a player for After School or School Holiday soccer programmes in Palmerston North.

Player details
First Name*
Surname*
Gender*
Date of Birth*
Club
School
 
Does the player have any medical conditions?*
If yes, please provide details
 
Parent/Guardian details
Parent/Guardian Name(s)*
Postal address*
Phone*
Email*
 
Enrolment details
Select registration Package*

*For Casual attendance, to purchase additional sessions or register another family member, please call Shane on 021 622 101 or make an enquiry.
 
Payment details
Select payment method*
 
Bank Account Details:
Account Number: 010178-0061855-00
 
Comments
Shane Rufer School of Football - CC44582 is a registered charitable entity in terms of the Charities Act 2005
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