At Mangawhai Activity Zone, Saturday 20th April, 2013, start 9:30am.
Student Name
Student Age
Guardians Name
Address
Phone Number
Mobile Number
E Mail
Emergency Contact Name
Emergency Contact Numbers
Medical Conditions
How are your skills? (select all that apply to you) beginnerolliekick flipdropin
How long have you been skateboarding for?
How did you find out about this?
What kind of skateboard do you have?
Go back to the coaching page to get your terms and conditions / liability waiver form.