Application Form

12 Week Program

Participants can do one of the following:

send a cheque or money order for $200* (payable to SealPony) to
116 Edwin Street, Heidelberg Heights 3081

OR

 make a direct deposit payment of $200* into our bank:
BSB 704-191; Account Number: 197980

OR

turn up in person on registration day to
make payment and collect equipment

* $200 fee includes soccer shirt, short, soccer ball & medallion at end of season. Alternatively you can pay $165 which only includes medallion at the conclusion of the season.

 

Fields marked with an ⚽️ are required

Type in any text and note it down to include with your payment so we can match the payment with this submission.

e.g. Preston Primary, John Smith, Google Search