RCP Member Registration

2021 Member Registration
Personal & Contact Details

Please complete one form per member.
Name: *

First Name Last Name
DOB: *

Day Month Year
Age (as at 31st August 2021): *
Your age determines which physie class you will be in.
Email: *
Please enter a valid email address.
Phone Number: *
Please enter a valid phone number.
Address: *

Street Address

Street Address Line 2

City State

Zip Code
Which school do you attend?
Only required for junior students aged 4-15yrs.
Emergency Contact 1: *

Full Name Contact Number
Emergency Contact 2:

Full Name Contact Number
Where did you hear about us? *

Word of mouth Google Newspaper Facebook/other social media Flyer Other
Please list any siblings or family members also registering with RCP (if applicable):
Please list any pre-existing medical conditions/injuries or allergies. If you have none, please type 'none'. *
We may contact you for further information where required.
Have you done physie before? *

Yes No
If you have done physie previously (outside of RCP), please let us know which club you last attended and the year you last competed.
Do you have a business/skill that might be of interest to the club?
Only applicable to adults.
Terms & Conditions

For all members under the age of 16yrs, a parent/carer is required to sign this form.
If my contact details change throughout the year, I will inform the club via email as soon as possible. *

I agree.
If I wish to withdraw from classes at RCP during the 2021 physie year, I will inform the club via email. I understand that class fees and registration will not be refunded. *

I agree.
The registration fee covers all regular scheduled lessons per week in accordance with the standard timetable. I understand that extra/private lessons made available to me will incur an extra cost. *

I agree.
The 2021 syllabus and music used in class have been supplied by BJP and are covered by copyright laws. I will not endanger the clubs access to use BJP media by making copies for my own use or distribution elsewhere. *

I agree.
I agree to follow the BJP member’s, parent and spectators Code of Conduct (as outlined in the members portal). I acknowledge that failure to follow the Code of Conduct may result in immediate loss of membership. *

I agree.
I agree to wear the correct class and competition attire to all lessons and competitions, as outlined on the RCP website. *

I agree.
On occasions, photos or videos are taken of club members and supporters. Do you allow your/your child’s photo to be taken and/or used in paper format publications (newsletters, newspapers, flyers, ect) AND in online format publications (club website, social media, ect)? *

Yes No (I understand that not giving my consent may result in me/my child missing out on club & class photos).
Signed:

Clear
Date:

Day Month Year
Date
Thank you for registering with RCP!

We can't wait to build strength through dance with you.
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

2021 Member Registration

Personal & Contact Details

Terms & Conditions

Thank you for registering with RCP!