REGISTRATION FORM

PRE-TRAINING REGISTRATION FORM

This must be completed prior to your first class.
Applicant's Name

First NameLast Name
Applicant's Date of Birth

DayMonthYear
Date
Applicant's Current Age:
Contact Email
example@example.com
Contact Phone Number

Area Code (61 for mobile numbers)Phone Number (Mobile numbers preferred)
Applicant's Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant's Occupation
If currently studying at school or university, type Student.

Acknowledgement

I, the undersigned, hereby acknowledge that all the information I have provided is true and correct at the time of signing.
Applicant's Signature
Date

MonthDayYear
Date
I received assistance from a parent or legal guardian in completing this form:
Parent or Legal Guardian's Name:

First NameLast Name
Contact Phone Number

Area Code (61 for mobile numbers)Phone Number (Mobiles preferred)
I, the applicant's parent or legal guardian, have read and understood the Training Contract, and have discussed its contents with the applicant, and am satisfied that the applicant understands and will abide by the conditions set out in the contract.
Parent or Legal Guardian's Signature:
Date

MonthDayYear
Date
Please verify that you are human
Should be Empty:

PRE-TRAINING REGISTRATION FORM