2025 EGC Registration Form

Elemental Gymnastics 2025 Registration
WAIVER INFORMATION
- I give permission for my child to attend classes at Elemental Gymnastics Club
- I understand that participation in gymnastics can pose some risk.
- I give permission for the staff of Elemental Gymnastics Club to administer first aid and obtain medical/ambulance assistance when required.
- I understand that for insurance purposes registration fees for Elemental Gymnastics Club and Gymnastics NT are to be paid before my child can participate in classes. *( Exception- The first class the child attends is a Come and Try )
- If my child is absent for 3 consecutive classes without any notification to the club;
  - The club will attempt to make contact with the relevant parent/guardian to determine your child’s intentions with the club.
  - If attempts to make contact are unsuccessful then he/she will be assumed to no longer be attending with fees being non-refundable.
- I understand that if my child is /has been hospitalised, has had surgery or any other long-term illness, upon returning to classes, a medical certificate from a medical professional may be required before recommencing training.
- I understand that Records will be kept in accordance to the privacy act.
I/We agree with the above*

YesNo

GYMNAST INFORMATION
Gymnast Full Name:*

First NameLast Name
Date of Birth:*

DayMonthYear
Gender

FemaleMaleOther
Does your Gymnast identify as Aboriginal and/or Torres Strait Islander?

NoYes
Returning Gymnast*
Has your gymnast participated in gymnastics classes previously?

YesNo
If yes, please explain:
Gymnast's Primary Address:*

Address

Street Address Line 2

City State

Postal Code
Gymnast's Phone contact (if over 18yrs old):
Please enter a valid phone number.
Gymnast's Email address (if over 18yrs old):
example@example.com
PARENT/GUARDIAN

If you are registering as an adult athlete, it is not required to fill out form below. Parents who register on behalf of their adult children, please fill out below. For minors, it is mandatory to have at least one parent/guardian contact. This is so we can contact you about your child's classes, invoice and in case of emergency.
Parent/Guardian 1:

First NameLast Name
Phone:
E-mail:
example@example.com
Relationship to Athlete
Parent/Guardian 2

First NameLast Name
Phone:
E-mail:
example@example.com
Relationship to Athlete
Address: (if address of Parent/Guardian 2 differs from Primary Address above)

Address

Street Address Line 2

City State

Postal Code
Media Approval Statement
By registering with Elemental Gymnastics, you accept that images, photos and video footage may be taken by authorised staff and used for marketing and promotion purposes on the Elemental Gymnastics website, publications or social media sites (names will NOT be included at anytime).

If a parent or guardian does not wish for their child (Under 18) or a member (over 18) to have their image taken or shared for these purposes, we will ensure your gymnasts' face will not be included.

If you have an issue with the above, please contact the club via elementalgymnastics@outlook.com or ask to speak to either our Head Coach or President.
I/we agree with the above media approval statement

YesNo

GYMNAST MEDICAL HISTORY
Please list any allergies that your gymnast has*
Type NIL if none
Please list any medical conditions that your gymnast has*
Type NIL if none
Please list any medications your gymnast takes on a regular basis or that may need to be administered at the gym*
Type NIL if none
Please list any additional support your gymnast may need with learning, communication, regulation or physical assistance*
Type NIL if none
Please list any current or recurring injuries including any previous bone fractures*
Type NIL if none
Please list any protective equipment or aids that you gymnast may wear/require*
Type NIL if none
Has your gymnast ever had a head, neck or spinal injury? If yes, please provide details*

CLUB INVOLVEMENT
Elemental Gymnastics is a not for profit club and therefore relies heavily of the assistance of it's members. Our coaches, administration and committee all volunteer their time to the running of the club.

If you are interested in getting more involved in the club, please indicate your interest below.
Select all that apply below:

I am interested in assisting with fundraising activitiesI am interested in assisting with competitionsI am interested in learning to become a judgeI am interested in learning to become a coachI am interested in joining the committeeAt this stage, I am not in a position to help out
Do you own a business and would like to become a partner and/or sponsor of Elemental Gymnastics? Your business will be promoted via our website, social media, at competitions and within our club.
Do you have any other comments or questions for our team?
Do you have a sibling(s) or additional children that will be registering as well? If so please indicate their name and age below (NOTE - you will need to complete a separate registration form for siblings also).
Should be Empty:

Elemental Gymnastics 2025 Registration

WAIVER INFORMATION

GYMNAST INFORMATION

PARENT/GUARDIAN

Media Approval Statement

GYMNAST MEDICAL HISTORY

CLASS SELECTION

CLUB INVOLVEMENT