KGC Membership Form

Karratha Gymnastics Club

Enrolment and Waitlist Form
Parent / Guardian Name*

PrefixFirst NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
Email is the primary form of communication from the Karratha Gymnastics Club - Please ensure you provide an email address that you check regularly. Invoices are sent via email, a late fee applies to overdue invoices, failure to pay will result in enrolment cancellation.
Phone Number*

Child #1
1) Child's Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Gender*
Has your child been previously registered with another club?*
Previous Club Name
Medical Conditions*
Physical, mental, behavioural, injuries, allergies, medications and any other relevant information. All medical information will be kept confidential. This information is crucial to our understanding of your child in a gymnastics environment. Please make us aware if a support worker will be accompanying your child during any classes.
Medical Details

Child #2
2) Child's Name

First NameLast Name
Date of Birth

DayMonthYear
Date
Gender
Previously Registered With Another Club?
Previous Club Name
Medical Conditions
Physical, mental, behavioural, injuries, allergies, medications and any other relevant information. All medical information will be kept confidential. This information is crucial to our understanding of your child in a gymnastics environment. Please make us aware if a support worker will be accompanying your child during any classes.
Medical Details

Child # 3
3) Child's Name

First NameLast Name
Date of Birth

DayMonthYear
Date
Gender
Previously Registered With Another Club?
Previous Club Name
Medical Conditions
Physical, mental, behavioural, injuries, allergies, medications and any other relevant information. All medical information will be kept confidential. This information is crucial to our understanding of your child in a gymnastics environment. Please make us aware if a support worker will be accompanying your child during any classes.
Medical Details

Karratha Gymnastics Club