Rec Centre - 6 wk Activity Course Enrolment

6 wk Activity Course Enrolment Form

Personal Details

First Name		Surname
Street Address		Postal Area
City & Postcode		Date Birth
Home Phone #		Mobile #
Email

How did you hear about us?

Google adverts	Nexus	website	student eNews	posters on campus
Facebook	Yellow online	email	word of mouth/friend	Uni events calendar
pull up banners	floor mat posters	other (please specify)

Course Details

Member ($55)
Non-member ($70) Membership Number:

Activity Course Name:

IMPORTANT PLEASE NOTE: OUR 6 WEEK ACTIVITY COURSES ARE NON-REFUNDABLE AND CANNOT BE TRANSFERED TO OTHER ACTIVITY COURSES

Note: online applications incurs a $3.00 processing fee – total charged to your credit card will be $58 for members and $73 for non members

Please click to acknowlege our no refund policy

Submit Form and pay with Credit Card at Flo2Cash