Luke Perry Volleyball Academy – Outside Hitter & Opposite Development Program with Tom Heptinstall - Perth Reds Volleyball Association

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Luke Perry Volleyball Academy

Outside Hitter & Opposite Development Program with Tom Heptinstall

Australian Volleyroo, Tom Heptinstall, is teaming up with the Luke Perry Volleyball Academy to deliver a Opposite and Outside Hitter Development Program on Monday nights at Aquinas College.

Athlete Information
Name*
First Last
Gender*
What is your age?*
Date of Birth*
DD slash MM slash YYYY
Email*
Enter Email Confirm Email
Mobile*
Address*
Street Address City ZIP / Postal Code
Local Government*
What Local Government Area do you reside in?
- City of Canning
- City of Melville
- City of South Perth
- Town of Victoria Park
Do you currently play WAVJL or WAVL for a club?*
- Yes
- No
If yes, which Club?*
Volleyball WA Membership Status*
What is your current Volleyball WA Membership Status? * Please note all athletes that wish to be involved in this program must have a Volleyball WA Gold or Platinum Membership.
- Platinum
- Gold
- Silver
- No Membership
Volleyball WA Membership Number*
Please enter your Volleyball WA Platinum or Gold Membership Number (Contact Code) in the field below. This membership provides athletes with Personal Accident Insurance. Your membership number is the Contact Code that can be found on your profile on the VWA Fortix website.
> FORTIX LINK
Your VWA membership status must be upgraded in order to register for this program. Please click on the link below to sign in or register on VWA’s Fortix system and purchase a Gold or Platinum Membership.
> FORTIX LINK Once you have your membership number please return to this form to register.
Emergency Contact Information
Emergency Contact Name*
Emergency Contact Relationship*
Emergency Contact Email*
Emergency Contact Mobile*
Association Requirements
Reds Membership Agreement*
I have read and agree to comply with the Reds Membership Agreement.
- Yes
Policies*
I agree to comply with all Association and Club policies.
- Yes
Associate Member*
I understand that by completing this membership I will become an Associate Member of the Perth Reds Volleyball Association and the Reds Volleyball Club.
- Yes
Program Information
Please choose number of sessions*
Please select the date of the session you will be attending*
Please select the days you will be attending*
- Monday 22 April
- Monday 29 April
- Monday 6 May
2024 LPVA Heptinstall Clinic - 1 day*
Credit Card Fees Apply
Price:
2024 LPVA Heptinstall Clinic - 2 days*
Credit Card Fees Apply
Price:
2024 LPVA Heptinstall Clinic - 3 sessions*
Credit Card Fees Apply
Price:
Credit Card*
Card Details
Cardholder Name

Perth Reds Volleyball Association

P.O. Box 102, Applecross, WA 6953

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Perth Reds Volleyball Association