Personal Training/Caregiving Booking Form

Personal Training/Caregiving Booking Form
Funding / Payee (All Stars is not NDIS register provider)*

Personally / Individually payingNDIS Self Managed (Individually Funded)NDIS Plan Managed - (under Core Supports - Line Item 04_300_0104_1_1 Access Community Social And Rec Activities ) or Accessing Self Care) OnlyOOHC - organisation paying
Number of sessions being booked*
Category Type*
Session Type*
Location*

All Stars Head Office
Location*

Your HomeYour Choice of Location
Training Location Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Personal/Client Details
NDIS # Number*
Client Full Name*

First NameLast Name
Client Date of birth*

DayMonthYear
Date
Client Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Client Primary/Secondary School (if applicable)
Client Phone Number (if applicable)
Client Email Address (if applicable)
example@example.com
Client Medical Information*
Emergency Contact Name & Ph Number*
Parent/Guardian Details (if applicable)
Parent or Guardian Name

First NameLast Name
Parent or Guardian Email
example@example.com
Parent or Guardian Phone Number

Area CodePhone Number
Parent or Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Does the parent or guardian confirm there are sufficient funds available for training & services ? By clicking ("YES") you guarantee that All Stars will be paid on completion of training & services

YesNo
Does the parent or guardian give consent / approval for funds to be released for training services to All Stars ?

YesNo
Finance Details
Accounts Contact Name*

First NameLast Name
Accounts Direct Phone Number*

Area CodePhone Number
Order Number
Accounts Email*
example@example.com
Amount to be Invoiced by All Stars (AUD). Please Include the Item Number and Line Item to be invoiced against.*
Support Coordinator Details
Support Coordinator's Name

First NameLast Name
Support Coordinator's Email
example@example.com
Support Coordinator's Phone Number

Area CodePhone Number
Plan Manager Details
Plan Manager Name

First NameLast Name
Plan Manager Email
example@example.com
Plan Manager Phone Number

Area CodePhone Number
Session Details
Date, Day/Time of Sessions Being Booked*
What do you want covered in the session?*
Additional Information
Terms & Conditions*

I agree to the terms & conditions of the booking & the student code of conduct (shown below)
By signing below you agree to the Terms & Conditions and hereby declare that the information provided is true and correct. *

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Terms & Conditions of Booking
Terms & Conditions
1.     Any and all training content and materials, will remain the intellectual property of All Stars Self Defence Centre’s Pty Ltd, and as such it is delivered commercially in confidence. (no sharing, copying, recording or photographs of any content without written permission or legal action will be sought against any entity breaching these terms. All training certificates are only valid for 12 month.

2.     Participants with Disabilities- enquire with our head office before booking online.

3.     Quotes are valid for 7 days. To accept this quotation, please send in written notification by email or our online booking page at www.allstarsdefence.com.au within 7 days of the program delivery date.

4.     Bookings online will only be taken, no phone booking will be accepted.

5.     Changes to booking; must be made 2 days prior in writing by email, no phone changes will be accepted.

6.     Invoices are payable 7 days from invoice date. Payment must be made by direct debit to the nominated bank account nominated on the invoice.

a.     all program Fees are payable in advance of program commencement. Where payment is not received by the program commencement, (All Stars Group) reserves the right to suspend delivery of the program until payment is received otherwise a debt collection agency will be engaged at your expense to collect funds outstanding.

7.     Cancellation and Postponement policy is as follows:

a.     no charge if the sessions are cancelled or postponed more than 7days prior to the training.

b.     a fee of the agreed fee is payable if the sessions are cancelled or postponed within 7 days of the scheduled dates.

c. a refundaable session paid in advance is required for any cancelations prior to starting is held as securioty of any no shows.

8.     Fees Unless specified are exclusive of travel cost for travel outside Metropolitan Melbourne.

9.     Cultural Safety – All Stars respect the rights of first peoples & their protocols of country & will follow all advice from Elders and Traditional Owners while providing training on country ie sorry business. We would also like to request the right to take photos or video during the training for marketing purposes, all photos will be de- identified on request.

10. Right of refusal - All Stars reserves the right to have students that won’t listen are rude and continue to disrupt the session, to be sat out for the duration of the session or removed from the class room for the remainder of the session or banned from attending any future classes with us.

11.   Guarantee - we guarantee to turn up to our booking or the next booking is free.

12.   Injuries, illness or special needs must be brought to the attention of the trainer before the course commences.

13.   Indemnity clause- The Client hereby absolves and indemnifies (All Stars Group) the providers and all their servants, agents, employees and other persons under the providers control (the "indemnified") from all liability arising for injury or damage (including but not limited to the, property and damage and / or personal injury, whether fatal or otherwise) however caused, including by the negligence of the indemnified, arising out of or connection with the program or participation in the program or in anyway caused by, or arising from the actions of (All Stars Group) . The Client has been advised of and understands that the practice of techniques demonstrated during the program is potentially dangerous.

Participant Code of Conduct
Student Code of Conduct

Objective
The Training Academy (“TTA”) has as its key objectives:

Providing instruction in a safe environment in the martial art of All Stars Self Defence Centres.

1.      Developing the mental and physical tools for improving personal safety and security.

2.      Promotion of good health and vitality.

3.      Development of positive self-esteem and self-confidence.

4.      Development of a person as a positive role model in the community.

5.      Creating expertise in confrontation management.

6.      Pro-active crime prevention through increased awareness and positive attitudes.

7.      Developing healthy community attitudes and values.

All persons participating in a class or course conducted by TTA must agree to be bound by this Code of Conduct. TTA reserves the right to make amendments or additions to this Code of Conduct at any time.

Participant Understanding
All Stars Self Defence Centre is a contact martial art, meaning it involves physical contact with one or more other practitioners in ways designed to simulate as closely as possible the self-defence options available to a practitioner when confronted with physical aggression and/or threatening behaviour. As in any other physically demanding recreational activity, there is always a risk of injury. Any person participating in a class conducted by TTA does so with the full understanding that whilst it is the policy of TTA to minimise this risk, the nature of contact physical activity prevents its total elimination. Persons participating in a class conducted by TTA do so of their own volition and at their own risk.

Safety
1. Persons must not wear jewellery or watches during training.

2. All persons participating in training agree to maintain self-control at all times and maintain all care in the application of any technique.

3. Any person who, in training, exhibits behaviour that, in the judgement of the Instructor, is a danger to other participants, shall not be allowed to continue training until the Instructor determines the danger is no longer present.

4. Any injury must be reported to the instructor in charge with all details of incident documented.

Training Area Etiquette
1. Persons will bow in the appropriate manner upon entering the Training Area.

2. Shoes must be taken off before entering the training area unless the shoes are special martial arts footwear approved by the Instructor (see “Clothing” below).

3. Persons must be punctual, preferably early, so that they are ready to train when class commences. If arriving late, a person must wait at the side of the Training Area until the Instructor indicates that a person may join the class.

4. Persons must not chew gum whilst training.

5. Food and/or drink (including water) must not be consumed whilst on the training area.

6. Mobile phones must be turned off during training. Mobile phones inadvertently left on during training may not be answered. Any person who is “on-call” for work may seek approval from the instructor prior to the commencement of class to leave his or her mobile phone on.

Uniforms & Training Gear
All Persons must wear the following approved clothing during all training sessions:

1. Pants: Plain white karate pants, and approved kickboxing shorts.

2. Tops: Plain white karate tops, and approved colour singlet or shirt for kickboxing.

3. Shoes: Only special martial arts training footwear which has been approved by the instructor.

4. Belts: Graded students must wear their belts.

5. All clothing must be free of all logos or markings unless the logo is that of TTA.

6. Persons inappropriately attired will not be allowed to train.

7. In addition to the general uniform requirements, persons must bring a towel and filled water bottle to each training session.

Sparring Requirements
1. Persons participating in sparring activity must purchase and wear an approved mouth guard and bring this mouth guard to every training session.

2. As boxing drills are a regular conditioning activity, persons are encouraged to purchase their own set of boxing mitts of an approved 14oz or 16oz size.

3. In addition to their personal mouth guards, persons participating in sparring must wear full protective clothing, either their own or as supplied by TTA, comprising body guards, head guards, shin guards, groin guards and 14oz or 16oz boxing mitts.

4. Sparring is to be of the non contact to touch contact kind during training sessions, all sparring is to be supervised by one senior ranked student at all times. (The ratio is 1 supervisor to 2 students sparring)

Sickness or Injury
1. Persons must not train if they are suffering from the flu or other viral infection that may be passed on to other persons.

2. Persons must advise the Instructor if suffering from any injury or medical condition, either permanent or temporary, which may be adversely affected by certain types of training.

Some examples of this may include blood pressure problems and cardiac disorders, neck and back injuries, diabetes and asthma.

3. If requested by the Instructor, persons with the above or like conditions must show this Code of Conduct to their physician and secure a medical certificate clearly stating that the person is able to participate in classes conducted by All Stars Self Defence Centres and whether there are any restrictions or conditions applicable.

Other Health Issues
1. Persons must not attend training under the influence of alcohol or illegal drugs.

2. Smoking is not allowed in the Training Area.

3. Persons training must give proper attention to personal hygiene and exhibit clean grooming; and ensure that fingernails and toenails are trimmed and clean..

4. Persons with a cut or bleeding injury must cease training immediately and receive appropriate first aid. Rejoining the training session will not be allowed until the instructor has deemed that is safe to do so.

5. Persons administering first aid to a person suffering a cut or bleeding injury must wear protective gloves.

Training Area Ethics
1. Persons must always be courteous and helpful to each other.

2. Physical contact between persons who are training must be appropriate to the situation and necessary for the skill development of those persons.

3. Sexual harassment, defined as being where a person is subjected to unwanted or uninvited sexual behaviour, will not be tolerated.

4. Any form of discrimination based on sex, ethnic origin, language, colour, or other form of differentiation will not be tolerated.

If found breaking any of the above rules may result in instant expulsion from the club and any or all titles, awards and or privileges being revoked.

Grading Conditions
1. Opportunity to grade under the TTA syllabus occurs only four times per calendar year. A person may only grade at these times subject to the final determination of the instructor.

2. Grading fees must be paid one month prior or no later than two week before the grading.

3. In assessing a person’s readiness to grade, the Instructor takes into consideration such factors as consistency of attendance, attitude, focus and attention during training sessions, as much as a person’s knowledge of the TTA syllabus to the point he or she wishes to grade.

4. To secure grading under the TTA syllabus a person must be a current financial member of TTA.

5. Membership of TTA requires a person to agree to be bound by this Code of Conduct.

6. TTA reserves the right to revoke the grading of any person who breaches this Code of Conduct or is convicted of any criminal offence.

Training Session Restrictions
1.      Training sessions with TTA are structured as either Conditioning Training Sessions or Technical Training Sessions with a 1-hour class usually comprising a Conditioning Training Session of 30 minutes followed by a Technical Training Session of 30 minutes.

2.      Only persons authorised by the Instructor are allowed to participate in any physical contact drills as required for gradings.

3.      Persons who commence training with TTA for the first time may take part in regular soft drill work, but no hard partner contact drill training for a period of 9 months or their first full grade, which ever comes first.


Medical
If you have a medical condition that the instructor should be aware of, you should notify him/her prior to training. During the course of training, if you become ill or have an injury, notify your instructor immediately. There is a difference with pushing yourself in training and putting up with a medical problem that may affect yourself and training.

Personal Hygiene
Students must maintain a level of cleanliness. Your hygiene also affects others.

1.      Fingers and toenails must be clean and short to avoid injury. With the quick movement of hands and feet during training, long or sharp nails can easily cut your opponent.

2.      Long hair can cause irritation to the eyes, distracting you at a critical moment during training. Long hair must be pulled back in a bun or ponytail.

3.      Your uniform must be clean and pressed and in good order.

4.      Keep your body clean. Make sure your hands are clean. Grimy hands will soil your uniform and other students’ uniforms and equipment.

5.      If you start bleeding in any way, shape or form, stop immediately and notify the instructor. Ensure that any blood is cleaned up properly prior to resuming training.

6.      Bad body odour is distracting and shows a lack of courtesy to others.

7.      Students must never come to class after drinking alcohol. It is too dangerous for everyone concerned.

Payment
All clients except NDIS or OOHC are required to make payment below for at least 1 session as a bond.

Payment will be refunded when invoice is paid after sessions are completed.
If asked for an ID number then please submit without payment as the payment amount may be the issue.
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Personal Training 30 min$70.00AUD

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Personal Training 40 min $90.00AUD

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