Individual Registration

Please enter your information in the form below to register for Level 3 Coaching Course (Hartleyvale Stadium).

First Name *

Last Name *

Email *

Mobile Number *

ID Number *

Date of Birth *

Gender *

Ethnicity *

Province *

Country *

What date did you receive your SAHA Level 2 Coaching Accreditation? *

Upload Your Hockey CV (PDF Only) *

Brief Summary of Coaching work in the past 3 years *

eg. u21 Wits Men, 1st team coach Paarl Gim, U18 SG A Boys

Payment Information

Sub Total (Ex VAT)

15% VAT

Total

Payment Method

Direct EFT Payment

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Terms and Conditions *

By registering for this course or event, I accept the Terms and Conditions

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