Beginners Umpire Course

Date: Saturday 26th January 2013

Venue: Brighton Aldridge Community Academy (BACA), Lewes Road,
Brighton, BN1 9PW
Time: 10:00am 2:00pm
Cost: 25.00 affiliated members
35.00 non-affiliated members

BOOKING FORM (PLEASE WRITE CLEARLY)

Name: _______________________________________________
Address: _____________________________________________
_____________________________________________________
Post Code ___________ Contact Number(s):_________________
E-mail:_____________________________________________
My AENA affiliation number is: ________________
Gender: Male Female

Date of Birth:______________

Do you have a disability: Yes No (pls tick as appropriate)

If yes, please specify: ___________________________________
Ethnicity: White Mixed Asian Asian/British Black
Black/British Chinese Other ______________To book, please
return this form along with a cheque made payable to Sussex County
Netball Association, By Friday 18th January to:
Hannah Brooks, Sussex Netball, University of Brighton Sports Centre,
Village Way, Falmer Campus, Brighton, BN1 9PH.
For more information please contact Hannah Brooks
hannah.brooks@englandnetball.co.uk