2024 Registration Form Term 1
Please complete all required information prior to commencing sessions.
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Email *
Student Information
Student First Name *
Surname *
Date Of Birth *
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Gender *
School *
2024 Class *
I am registering my child for the FREE AeroGym program at Recess on Fridays *
Note: Free 8 week program at recess on Thursday/Friday TBC - Wear sport uniform and take a water bottle to each session. Commencing Week 1 February 9
Please list any medical conditions including injuries, allergies and medications: (please email asthma/anaphylaxis plans to aerogym@bigpond.com)
Parent/Guardian's Details
Full Name *
Relationship *
Mobile Phone *
Consent & Authority
I have chosen to have my child participate in dance/gymnastics/aerobic instruction. I acknowledge that I understand the nature of the activities my child will be participating in and that my child is in the proper physical condition and capable of participating in the related activities, understanding that AeroGym staff are not in any way responsible for making such a determination. In consideration of my child’s participation in the program, I understand and agree on behalf of myself and my child, to release, hold harmless, and discharge AeroGym & coaches from all claims, costs, liabilities, expenses or judgments, including medical &  legal fees and court costs for any occurrences in connection with any program instruction. I assume all risks to my child in connection with any instruction and further release all coaches from liability for any injury sustained by my child while he or she is enrolled in any instruction program, including all risks reasonably connected with such activity whether foreseen or unforeseen. I acknowledge and agree that it is my responsibility to maintain my own accident and health insurance coverage that provides adequate coverage for myself and my child while attending sessions. I authorise and agree that coaches may take and use photographs or videos of my child as needed for training, competition, advertising and/or public relations projects and social media and give on going consent to this. No refunds are given for missed sessions or school absence. It is the responsibility of students to arrive on time for the commencement of sessions. Up to 50% refund of the term fee is possible for students who withdraw due to injury/illness upon presentation of a medical certificate. All program enquires, concerns, feedback etc should be directed to the Program Director not school staff. I agree to respect all team selections and levels allocations as determined by AeroGym coaching staff.
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A copy of your responses will be emailed to the address you provided.
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