Please print this page, fill out and send to the coordinator at the address below
Junior Angler Education APPLICATION FORM
I wish to attend the Sunfish (QLD) Fraser Coast Junior Angler Education Clinic
on ___, ___________, 200__.
Name: _________________________________________
Address: _________________________________________
Contact Phone: ___________________________ Age:_______ yrs.
Enclosed Payment:-$_________________ Receipt Required:- Yes / No
Are there any special needs of the child i.e. medical allergies etc?
_________________________________________________________
_________________________________________________________
Please circle one, which best describes your fishing experience:-
None / Some / A Lot / Experienced
As a parent or guardian do you have any objection to your child or children’s activites being photographed (but not named) for possible use in future Sunfish Fraser Coast promotions. Yes / No
Parent Guardian Signature: ___________________________
+++++++++++++++++++ cut and keep bottom portion ++++++++++++++++++
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Sunfish Fraser Coast Junior Angler Education Program
Your copy of
APPLICATION FORM
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Instructor
Bill SHERBURN
92 Limpus Street
URANGAN 4655
PHONE: 4125 2198, Mob: 0407 252 198
OR 4128 0700.
All Clinics Take Place at the Urangan Pier Reserve, 9.00am to 3.00pm.
I will be attending the clinic on:-
- All fishing gear and food is supplied. (courtesy of our angler ed supporters)
- All instructors and helpers have a blue card
- Please ensure the child has a Broad Brimmed Hat.- Sunscreen is supplied.
- Please be at the Pier Recreation Area by 8.00 am on the day. We finish at 3.00 pm.
- Please make payment of $25.00 at least 1 week prior to clinic, as we need to know the numbers for catering purposes.
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Fisherman's Corner
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Bunnings Hardware
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Shimano Tackle
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Woolworth's Pialba
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Halco Lures
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Wilson Tackle
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Tropical Ice Boxes
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Diawa tackle
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Gladiator Tackle
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BACK
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