Clone of Kids Gymnastics Term Three 2025

Murchison Sport, Recreation & Cultural Centre

82 Waller Street

Murchison 7007

murchison.centre@gmail.com

03 523 9360

021 426 981

ATTENDEES DETAILS

Attendee #1*

First NameLast Name

Age (if under 18 years)

Attendee #2 (Optional)

First NameLast Name

Age (if under 18 years)

Attendee #3 (Optional)

First NameLast Name

Age (if under 18 years)

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Contact Phone Number*

Area CodePhone Number

PRIMARY CAREGIVER DETAILS IF UNDER 18 YEARS - Please fill out the Childs primary caregiver details below, this is the person we would communicate with about Karate.

Primary Caregiver Name

First NameLast Name

Primary Caregiver Contact Phone Number

Area CodePhone Number

Primary Caregiver Email

example@example.com

REGISTRATION DETAILS -

All registered children must be 6 years & over.

Karate for term 2 will be on Tuesday, starting 28th April through to 30th June (10 sessions).

The sessions will run from 5-6pm.

Registration requires payment up front for the term.

No refunds will be provided.

Registration Costs are $40.00 per term per attendee.

To be paid to MSRCC 03-1354-0144276-02 Ref: attendees name

PHOTOGRAPHS: I consent to myself/child being photographed and these photographs to be used in any media coverage in regards to the promotion of the programme*

EMERGENCY CONTACTS & PEOPLE AUTHORISED TO COLLECT YOUR CHILD(REN)
Please list people who are to be contacted in an Emergency, if we are unable to reach you. These contacts will also be authorised to collect your child(ren).

NameContact Number

MEDICAL REQUIREMENTS / OTHER INFORMATION
Detail below any Medical or Other requirements for yourself/Child(ren).

MEDICAL REQUIREMENTS: Are there any health needs we need to be aware of for you or your child(ren) – e.g. asthma, medical conditions, allergies, disabilities? (If this form is for more than one child, please clearly indicate for whom the health needs apply). Also, If your Child(ren) are required to have medication with them please indicate this below and if any assistance is required in taking the medication.

PRIVACY ACT
The information supplied on this form will be held securely in the MSRCC Office and used only for the safe and effective operation of our Karate programme. Attendees or Parents/Guardians of registered Children are welcome to view and/or update this information at any time by contacting the MSRCC Management Team.

INJUIRES & FIRST AID

Injury can occur during Karate and it is a high-risk sport. Coaches use their discretion to determine the difference between a minor and major incident when administering First Aid.

In the case of a minor injury, the coach will take the appropriate First Aid response. After a short rest, the attendee will continue training or can be taken home by their parent or caregiver.

In the unlikely event of a medical emergency, First Aid will be administered, including requesting an ambulance if needed. If the parent/caregiver is not at the Centre when this injury occurs, you will be contacted using the emergency contact information we have on file for you. Your instructions will be followed from that point on.

In the event we are unable to make contact with a parent/caregiver, we will make arrangements to travel to the Accident and Emergency Centre closest to us. A staff member will remain with the attendee until the parent/caregiver have arrived and been fully briefed.

ATTENDEE OR PARENT/GUARDIAN DECLARATION
By completing and signing this form, MSRCC has your or the Parent/Guardians permission to arrange any urgent medical treatment for yourself or the child(ren) listed above. This will be at the Parent/Guardians cost. Should the need arise, minor first aid will be
administered by one of the trained programme staff on site.

I confirm have read and understood the above. What I have written is true and accurate and I have not withheld any information, especially about my child(ren)'s health.

Signature of Attendee or Primary Caregiver if under 18 years*

Date*

Date

Karate Term 2 2026 Registration