Pack A - Fiddes Direct

SUMMER 18/19 SEASON
Central City BREAKERS
Order Form

$ 170

1. Uniform with reversible singlet $100.00
2. Breakers printed Tee Shirt $20.00
3. Breakers Hoodie or Warm u top $50.00
4. Breakers Socks with woven logo $15.00
5. Breakers Hand Towel with club embroidery $15.00

Date

Player's Name

Delivery Address

Players Date of Birth

Sex

Male Female

Parent's / Guardian's Name

Singlet Number Now:

Requested Number

Singlet Number Club Allocated

Pack A $170

Uniform with reversible singlet $100

Breakers printed Tee Shirt $20

Warm Up Top $50

Name on Warm Up Top

Breakers Hoodie $50

Name on Hoodie

Breakers Socks with woven logo $15

Breakers Hand Towel with club embroidery $15

Delivery $10

Payment Method

If paying by card, then please complete the following:

Name on Card

Card Number

Expiry Month

Expiry Yr

CVC

If paying by direct deposit please direct payment to:
Fiddes Sport
BSB: 063184
Account: 1042 8368
Please use code “CCB” followed by your SURNAME, on your bank transfer.

FIDDES SPORT
Phone: 03 9464 1721
Mobile: 0400 555 255
Address: Factory 15, 24 Brand Drive, THOMASTOWN, 3074
fiddes@fiddes.com.au

SUMMER 18/19 SEASON Central City BREAKERS Order Form

Pack A Basic Starter Pack

Pack A $170

FIDDES SPORT Phone: 03 9464 1721 Mobile: 0400 555 255 Address: Factory 15, 24 Brand Drive, THOMASTOWN, 3074 fiddes@fiddes.com.au

SUMMER 18/19 SEASON
Central City BREAKERS
Order Form

Pack A
Basic Starter Pack

FIDDES SPORT
Phone: 03 9464 1721
Mobile: 0400 555 255
Address: Factory 15, 24 Brand Drive, THOMASTOWN, 3074
fiddes@fiddes.com.au