Enrolment Form

You will be contacted upon receiving a place in a class. This form is to apply for a place.

To enrol many attendees, complete this form once for each attendee.

Contact Name:	*
Participant:	*
Phone number:	*      Gender: --choose-- Male Female *
Emercency contact:	* (Phone/mobile number)
Email:	Date of Birth: *
Address:	*
Programmes:	Preschool Recreational Trampoline
Comments:	Please specify class and preferred day/time and a second choice:
Previous Gymnastics Experience:
	How did you hear about us?
	Are there any services that you as a parent/guardian could provide to improve our club?
Medical History
	Please provide details of any, physical or intellectual condition that may have a bearing on your child’s ability, safety or behaviour in class:
	Is your child on any medication, which we should be aware of?
	Does your child suffer from any allergies, which we should be aware of?
Parents/Caregivers expectations
	Your expectations are important to us in delivering a quality service. What do you hope your child will gain through our programmes?
Terms and Conditions:	I give permission for my child to be photographed/videoed while participating in any club activities and consent to these being used for publicity if required. I give permission for my child to receive medical/ambulance assistance in case of emergency and agree to pay any costs incurred. I understand that I may access my child’s personal information held by the club. I understand that a formal registration policy is recorded and is available upon request The information provided on this form is complete and correct to the best of my knowledge and I undertake to advise the club promptly of any changes that may occur I have read and understood this enrolment application and club rules and agree to the terms and conditions stated therein. I agree to these terms and conditions
	* = required

The information contained within this form will be used primarily for matters specifically related to participating in gymnastics and/or if a secondary purpose is related to the primary purpose and one could reasonably expect such use or disclosure.

To assist in providing our services, the organisations to which we disclose information include :-
NZ Gymnastics, Canterbury Gymnastics, Our Insurers, The Sport Education Sector, our accountants, lawyers auditors, Government and regulatory authorities and other organisations, as required or authorised by law. We limit the use and disclosure of any personal information provided by us to provide you with the services you require, or the level of service on which we pride ourselves on.
If you chose not to provide personal information, we may not be able to provide you with the services you require, or the level of service on which we pride ourselves.

Disclaimer
Participation in Gymnastics activities carries with it a reasonable assumption of risk. Please note that this information is not intended to constitute legal advice, and is provided as general information only. You should not rely on it without first verifying the accuracy, completeness and currency of the material, and its relevance to your individual circumstances.

Mission Statement
To provide quality, affordable gymnastics programmes in a safe and secure environment, which will enhance the fitness and active wellbeing of the community.