Membership Form Seacliff Calisthenics Club

Child's/Member's information:

A separate form is to be used for each child/member registering.

Name*

First Last

Date of birth*

Please select group your child/you will be joining*

Tiny Tots: 3 to 5 years - Born 2016 to 2017
Tinies: 5 to 7 years - Born 2016 to 2014
Sub Juniors: 8 to 10 years - Born 2013 to 2011
Juniors: 11 to 13 years - Born 2010 to 2008
Inters: 14 to 17 years - Born 2008 to 2005
Seniors: 18 years & over - Born 2003 and earlier

All ages must be as at 31 December 2021.

Address*

Street Address Suburb State Post code

Phone no:*

Mobile no:*

Email address:*

Select one of the following:*

New member
Existing member
Life member

New members please enter below the previous Calisthenics Club and year last registered (if within 3 years) -

Year:

Club:

Transfer form provided with this enrolment (new members only if applicable)

Yes
No

Transfer Form to be sent to club secretary via email to secretary@seacliffcalisthenicsclub.com.au or please provide hard copy at the desk.

MEDICAL AWARENESS INFORMATION:

It is the responsibility of all parents / caregivers to notify the Seacliff Calisthenics Club of any medical condition and supply labelled medication if necessary (eg asthma, allergies etc). In the event of an emergency an ambulance will be called (Any costs incurred will be the responsibility of the member).

PLEASE INCLUDE THE MEDICARE NUMBER APPLICABLE TO THE CHILD/MEMBER:

Medicare number:*

Reference no:*

Expiry date:*

Please list any medical details and action plan here:

Emergency contact name:*
Name

Phone number:*

PROMOTION MATERIAL:

Consent is required to photograph and /or name to be used in promotional / programme material for the Seacliff Calisthenics Club. I have read and acknowledged the above information. Please select from the two options below.

Select option*

Child's/Member's name:*

Signed (name):*

Date*
DD dash MM dash YYYY

PAYMENT IS NOW DUE:

Person responsible for payment*
First name Last name

Today's date*
DD dash MM dash YYYY

Please tick this box*
I have read, agree to and understand the terms and conditions of membership

If you do not agree to the terms and conditions you will be unable to submit your form online. Please contact the Club President Annette Simpson to discuss your concerns.

Membership Form Payment Options*

Bank Transfer (paid today after form submitted) preferred payment method.

Cash or card (paid at the club) * Please note no additional charges when paying via debit or credit card.

Payment of Fees & Costume account to be made*

IN FULL

VIA INSTALMENT OPTION
You can read about the instalment options on our Agreement form, by clicking HERE

Sports voucher - $100

ONE VOUCHER FOR EVERY PRIMARY SCHOOL AGED CHILD PER CALENDAR YEAR. HARD COPIES ARE AVAILABLE AT THE CLUB.

Will you be submitting the $100 government sports voucher with your child’s registration?

Yes

No

Please click on this link - DOWNLOAD 2021 SPORTS VOUCHER - save to your computer first (do not fill it in online as it doesn't save your details), once saved to your computer please fill in and save the PDF with your child's name to help us locate each form, then use the choose file button below to submit it back to us.

Once sports voucher is filled in, please upload*
Max. file size: 20 MB.

Hidden

Name
First Last

Hidden

Date of birth

Day
Month
Year

Hidden

My child is attending or is eligible to attend primary school (Years R-7) in 2021

Yes

No

Hidden

Member of sports club prior to using voucher

Yes

No

Hidden

I confirm my child has not already claimed a voucher in 2021

Yes

No

BANK DETAILS:

If paying via Bank transfer option -
BSB: 015-220 (ANZ)
Account No. 230561057
Account Name: SCRA/Calisthenics
Reference: Surname and Initial e.g. SMITH M

2021 FEE STRUCTURE

A membership fee of $115 which covers CASA Registration, Insurance, Building Levy and associated costs is payable by 28th January 2021. Please click here to view the Seacliff Calisthenics 2021 Fee options. Once chosen, please pay via the payment option chosen above.

CAPTCHA

2021 MEMBERSHIP FORM – SEACLIFF CALISTHENICS CLUB

MEMBERSHIP FORM 2021

Child's/Member's information:

MEDICAL AWARENESS INFORMATION:

PROMOTION MATERIAL:

PAYMENT IS NOW DUE:

Sports voucher - $100

BANK DETAILS:

2021 FEE STRUCTURE