Skipping Australia Athlete Membership Form - Pumper Jumpers
Welcome to the 2021 Skipping Australia Membership Form. Full details, eligibility and benefits of being  a Skipping Australia Member can be found https://docs.google.com/document/d/1a8sbW0TwiY_mSNVGrOb4iIwMv2bX2kPOftp65qPQTxE/edit?usp=sharing   
Skipping Australia will collect membership fees via your club


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Email *
Athlete First Name *
Athlete Surname *
Athlete Date of Birth *
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DD
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YYYY
Athlete Gender *
Athlete home address including suburb, state and postcode *
Athlete contact phone number *
Athlete contact email address *
Emergency Contact  - Name *
Emergency Contact - Phone Number *
Relationship to athlete *
If the athlete is under 18, please provide full name of Parent/Carer  (If the same as the emergency contact details above, enter 'as above')
Parent/Carer contact number (If the same as the emergency contact details above, enter 'as above')
Athletes Classification *
Does the athlete have any medical conditions that Skipping Australia or your club need to be aware of? *
Do you give permission for any photos or videos of the athlete to be used by your club, state/territory skipping association or Skipping Australia to be used for promotional purposes? *
COMPLIMENTARY AFFILIATE MEMBERSHIP
A maximum of four parent/guardian/family members are offered complimentary membership for each competitive athlete or recreation skipper under the age of 18.  We encourage you to take up as many of these membership spots as possible to help us maintain the minimum membership numbers required to maintain our status as a national sporting organisation.  Thanks for taking the time to complete this extra detail.
Complimentary Membership #1  Parent/Guardian/Family Member - Name and email
Complimentary Membership #2 Parent/Guardian/Family Member - Name and email
Complimentary Membership #3  Parent/Guardian/Family Member - Name and email
Complimentary Membership #4  Parent/Guardian/Family Member - Name and email
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