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*

DD

MM

YYYY

Please select group your child/you will be joining*

Tiny Tots: 3 to 5 years - Born 2014 to 2016
Tinies: 5 to 7 years - Born 2014 to 2012
Sub Juniors: 8 to 10 years - Born 2011 to 2009
Juniors: 11 to 13 years - Born 2008 to 2006
Inters: 14 to 17 years - Born 2006 to 2003
Seniors: 18 years & over - Born 2001 and earlier

All ages must be as at 31 December 2019.

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 2 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*
Date Format: DD dash MM dash YYYY

PAYMENT IS NOW DUE:

Person responsible for payment*
First name Last name

Today's date*
Date Format: 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 cheque (paid at the club)

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

Do you wish to submit the $100 government sports voucher with your child’s registration?*
Yes
No

Please click on this link - DOWNLOAD 2019 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*

Name
First Last

Date of birth

DD
MM
YYYY

My child is attending or is eligible to attend primary school (Years R-7) in 2019
Yes
No

Member of sports club prior to using voucher
Yes
No

I confirm my child has not already claimed a voucher in 2019
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

2019 FEE STRUCTURE

A membership fee of $110 which covers CASA Registration, Insurance, Building Levy and associated costs is payable by 31st January 2019. Please click here to view the Seacliff Calisthenics 2019 Fee options. Once chosen, please pay via the payment option chosen above.

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2019 MEMBERSHIP FORM – SEACLIFF CALISTHENICS CLUB

MEMBERSHIP FORM 2019