rhythmiQ | Registration form 2025/26
Designed for children with parents in mind
Please select a type of class and the preferred time slot(s) in Section 4 of the form below. We will get back to you to confirm availability and tell you about next steps. This form allows to register up to two children for a similar type of class. If registering more children or for different types of classes please complete separate forms. For terms and conditions please scroll to the bottom of this form.
Membership status
I am registering as a new member (including a trial)
I am an existing member updating details
1. Parent/guardian details
Name
*
First Name
Last Name
Relationship to the child
Phone number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2. Emergency contact details
Name
First Name
Last Name
Relationship to the child
Phone number
Please enter a valid phone number.
Email
example@example.com
3. Child details
Child's name
*
First Name
Last Name
Month and year of birth
*
Current school year group
Please Select
Reception
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Year 11
Year 12
Which school does your child attend? [This is optional and helps us understand our local reach. Leaving this blank won't affect your child's participation.]
Skill level
*
Beginner (no previous training experience)
Training in other type(s) of gymnastics
Training in rhythmic gymnastics
Training in ballet
Other
Previous training experience
Medical information/special requirements we should be aware of
*
I give permission for qualified staff to administer first aid to my child during rhythmic gymnastics sessions, including seeking emergency medical treatment if necessary. [Selecting 'No' won't affect your child's participation - we'll always contact you first if possible.]
*
Yes
No
Add another child?
Add another child
Child's name
*
First Name
Last Name
Month and year of birth
*
Current school year group
Please Select
Nursery/Reception
Year 1
Year 2
Year 3
Year 4
Year 5
Year 6
Year 7
Year 8
Year 9
Year 10
Year 11
Year 12
Which school does your child attend? [This is optional and helps us understand our local reach. Leaving this blank won't affect your child's participation.]
Skill level
*
Beginner (no previous training experience)
Training in other type(s) of gymnastics
Training in rhythmic gymnastics
Training in ballet
Other
Previous training experience
Medical information/special requirements we should be aware of
*
I give permission for qualified staff to administer first aid to my child during rhythmic gymnastics sessions, including seeking emergency medical treatment if necessary. [Selecting 'No' won't affect your child's participation - we'll always contact you first if possible.]
*
Yes
No
4. Class selection
Type of class you are interested in
*
Trial (free)
Recreational (1.5hrs one session a week)
Advanced (3-4hrs over two sessions a week)
Competitive (6+ hrs over three sessions a week)
Free class (gift voucher)
Voucher number
*
Trial or free class selection
*
/
Day
/
Month
Year
Date
Select preferred day(s) and time of training
Worcester Park Baptist Church - Tue 4.15pm-5.15pm FIRST-STEPS
Worcester Park Baptist Church - Tue 5pm-6.30pm TAKE-OFF, HIGH-FLYERS
Worcester Park Baptist Church - Tue 6.15pm-7.45pm TAKE-OFF, HIGH-FLYERS
Homefield Preparatory School - Thu 6pm-7.30pm TAKE-OFF, HIGH-FLYERS
Homefield Preparatory School - Sun 10.30am-11.30am FIRST-STEPS
Homefield Preparatory School - Sun 11.15am-12.45pm TAKE-OFF, HIGH-FLYERS
Homefield Preparatory School - Sun 12.30pm-2pm TAKE-OFF, HIGH-FLYERS
5. Other updates
Please tell us if there are any changes to contact details, medical information or other notes we should know.
6. Photo & video permissions
I give permission for my child photos/videos to be used for club communications (website, social media, flyers, etc.). [This is only for publicity. Selecting 'No 'won't affect your child's participation.]
*
Yes
No
I give permission for my child to be recorded on video for the sole purpose of coaches' training and assessment (e.g. submission to British Gymnastics to receive coaching qualifications). These videos will not be used publicly. [Selecting 'No' won't impact your child's participation. Videos are strictly for internal training and assessment.]
*
Yes
No
7. Other information
Would you be interested in the minibus service to collect and return children before and after training? If yes, please select the route of interest
No, not interested
Route 1. Carshalton area (Carshalton Park Road - Hawthorn Road - The Warren - The Horseshoe)
Route 2. Wimbledon area (Mostyn Road - Sheridan Road)
Route 3. Wimbledon area (Cambridge Road - Dudley Road - Burstow Road - St Helier Avenue)
Route 4. Worcester Park area (Cuddington Bowls Club - The Manor Drive (near the Hollands) - Green Lane (near the Hamptons) - Langley Avenue)
Route 5. Epsom area (Chertsey Lane - Windmill Lane (exit of Alexandra Recreation Ground) - Nonsuch Court Avenue)
How did you hear about us?
Leaflet
Facebook
School communication
Word of mouth
Outdoor banner
Other
Print
Save
Submit
Should be Empty: