Belrose Physie 2025 Free Trial
2 classes Free. Full term fees apply from your 3rd class.
Student Name
First Name
Middle Name
Last Name
Date of Birth
*
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Day
-
Month
Year
Date
Age as of 31/08/2025
*
Address
Street Number
Street Name
Suburb
State
Postcode
E-mail
*
Parents/Guardians Names
Not required for over 18s
Phone Number(s)
*
Please provide both parents contact numbers if under 18
Medications/ allergies
If yes then please provide us with a copy of your child's emergency action plan i.e anaphylactic/asthmatic
Emergency Contact Name/Number
This person should NOT be a parent but a someone you trust that we can contact if we are unable to contact a parent. Please all fill this out including over 18s.
Class Selection- please choose 1 class to trial
*
MON 13-1st Year Seniors
MON 2nd Year, Novice & Open Seniors
MON Ladies
WED 4-6s
WED 7-8s
WED 9-10s
WED 11-12s
WED 13-1st Years
SAT Tinies
SAT 4-8s
SAT Stretch (Must be enrolled in a physie class to attend)
SAT 9-12s
SAT 2nd Year, Novice & Open Seniors
SAT Ladies
How did you hear about us?
*
Friend
Current member
Social Media
Other
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