Learn to KinderGym NT

Learn to KinderGym NT

NT Government supported voucher program
Participant Information

Please provide details about the KinderGym participant.
Participant's Full Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
FemaleMaleNon-binary/third gender
Participant's Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Family Email (if applicable)
example@example.com
Family Phone Number (if applicable)
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Information

Contact details for the parent or legal guardian.
Parent/Guardian Full Name*

First NameLast Name
Relationship to Participant*
Parent/Guardian Email*
example@example.com
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Information

Provide an emergency contact other than the parent/guardian listed above.
Emergency Contact Name*

First NameLast Name
Emergency Contact Relationship*
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Preferred NT KinderGym Club

Select the gymnastics club you wish to enrol KinderGym participant in.
Darwin Gymnastic Club - MarraraElemental Gymnastics Club - WoolnerTerritory Gymnastics Academy - Wiinnellie
Medical Information

Please inform us of any relevant medical details.
Does the participant have any allergies or medical conditions? Please specify.
Is the participant currently taking any medications? Please list if applicable.
Additional Information

Share any other important details or special considerations.
Additional comments or information (optional)
Youtube
Consent and Agreement

Parental/guardian consent is required for participation.
Gymnastics Australia (GA) / Gymnastics NT (GNT) National Privacy Policy
The national privacy policy sets out how GA/GNT may collect, hold and use personal information. By providing your personal information to GA, you consent to its use, storage and disclosure in accordance with this Privacy Policy. https://kindergymnt.com.au/contact/privacy-policy
Should be Empty:

Learn to KinderGym NT

Participant Information

Parent/Guardian Information

Emergency Contact Information

Preferred NT KinderGym Club

Medical Information

Additional Information

Consent and Agreement