EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM
$59.99 / session | Session Payments via Square
Welcome to VIRTUS Centre. Please complete all sections of this form fully and honestly before proceeding to payment. Submitting this form constitutes a legally binding agreement between you, your parent/guardian, and VIRTUS Centre.
SECTION 1 — PERSONAL DETAILS
Athlete Full Legal Name
Date of Birth

MonthDayYear
Age
Gender
Athlete Email Address (if applicable)
example@example.com
Parent/Guardian Name
Parent/Guardian Number
Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
SECTION 2 — PRE-EXERCISE HEALTH SCREEN (PSS-YP V1 2021)
Based on the ESSA Pre-Exercise Screening System for Young People (PSS-YP) V1, 2021. This tool is designed to identify any young person with medical conditions or warming signs that may put them at higher risk during exercise sessions.
Pre-exercise screening results are kept confidential and shared only among individuals involved in urgent medical care, and/or with consent of the young person and/or parent/guardian.
To be completed with an exercise professional or individual responsible for the medical care of the young person.

STAGE 1 (COMPULSORY)- Do you have, or previously had:

Rows	YES	DON'T KNOW	NO
1. A heart condition?
2. A close relative who has died suddenly from a heart condition before the age of 50?
3. Uncontrolled epilepsy or seizures/convulsions?
4. Fainting or dizzy spells with physical activity/exercise?
5. Diabetes?

VIRTUS Centre | seb@virtuscentre.com.au | info@virtuscentre.com.au | Confidential Member Agreement

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM
$59.99/session | Session Payments via Square
for a complete and balanced weekly development stimulus
Program Inclusions:
- Annual athletic development program tailored to youth athletes
- Expert coaching focused on age-appropriate speed, power, and strength development
- Access to House of VIRTUS Centre — Skool Community (open to parents & athletes):
  - Private community with daily content uploads
  - Extensive training resources and education
  - Direct communication with coaches and the entire VIRTUS community
Nominated Weekly Session Type:
Start Date:
SECTION 4 — LIABILITY WAIVER & MEDIA CONSENT
Physical Condition Declaration:
By proceeding with this form, you represent to VIRTUS Centre that to the best of your knowledge the athlete is in good physical health and has no medical or physical condition that would prevent safe participation in the Emerging Athlete Program.
Risk Warming & Liability Waiver:
VIRTUS Centre warns that whilst the athlete is on the premises using the facility and its services, there is a risk of injury. By ticking below, you acknowledge that
- The athlete is voluntarily participating in activities at VIRTUS Centre
- Physical exercise involves inherent risk of injury or death
- VIRTUS Centre, its coaches and staff are not liable for any injury, illness, loss or damage suffered while using the facility or participating in programs.
- You have disclosed all known medical conditions in Section 2 of this form
- The athlete is responsible for ensuring they are fit to participate
- In an emergency, VIRTUS Centre staff are authorised to call emergency services and administer basic first aid on behalf of the athlete
VIRTUS Centre | seb@virtuscentre.com.au | info@virtuscentre.com.au | Confidential Member Agreement

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM
$59.99 / session | Session Payments via Square
Video Surveillance:
For security purposes, VIRTUS Centre uses video surveillance equipment to monitor
the facility. Cameras are in training floor areas only — not in change rooms,
toilets or private spaces. Footage is stored securely and used only for safety purposes.
Media ConsentVIRTUS Centre may capture photos and videos during training sessions and general gymuse for educational, promotional, and social media purposes.
SECTION 5 — PAYMENT TERMS & FAILED PAYMENTS
By signing this agreement, you agree to the following payment terms:
- All membership fees must be paid weekly in advance via Square recurring billing
- Payments are automatically deducted from your nominated billing account
- VIRTUS Centre does not offer refunds on processed weekly payments
- In the event of a failed payment, a dishonour fee of $5.50 will apply
- Repeated failed payments may result in suspension or termination of membership
- It is your responsibility to ensure sufficient funds are always available
- VIRTUS Centre will provide 30 days written notice of any fee changes
SECTION 6 — COOLING OFF PERIOD
All new VIRTUS Centre memberships are subject to a 48-hour cooling off period beginning
from the date of form submission.
- If you wish to cancel within 48 hours of signing up, contact VIRTUS Centre in writing
VIRTUS Centre | seb@virtuscentre.com.au | info@virtuscentre.com.au | Confidential Member Agreement

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM
$59.99 / session | Session Payments via Square
- A $4.99 administration fee applies to all cooling off period cancellations
- After 48 hours, the standard cancellation policy applies (see Section 7)
SECTION 7 — CANCELLATION & NO-SHOW POLICY
Understanding the Value of the Emerging Athlete Program:
The Emerging Athlete Program is a structured, high-value group coaching service designed specifically for youth athletic development. Your coach prepares individualised development. plans, session structures, and progressions every week regardless of your athlete's attendance. The investment in your athlete's development does not pause because a session is missed.

For this reason, your weekly membership fee is payable in full regardless of attendance, unless the membership is formally paused or cancelled in accordance with the policies below.
Session Attendance & No-Show Policy:
- If the athlete does not attend their nominated session, the weekly membership fee will be deducted as normal. Non-attendance does not qualify for a refund or credit.
- If the athlete is unable to attend, they are encouraged to attend an alternative available session within the same week.
- Repeated unexplained absences may result in a review of the membership.
▲ The only exceptions to weekly fee deductions are formally approved membership pauses or cancellations as outlined in Sections 8 and 9.
Cancellation by Member:
- Cancellations must be submitted in writing via email to VIRTUS Centre.
- A minimum of 14 days written notice is required.
- The account must be in good standing — all fees paid and up to date.
- VIRTUS Centre does not offer refunds on processed weekly payments.
- Any payments processed within the 14-day notice period are non-refundable.
- Termination for medical reasons must be accompanied by a medical certificate.
- In the event of death, the estate must provide a death certificate and any unused fees will be refunded.
Termination by VIRTUS Centre:
- Fails to make any payment of membership fees
- Breaches any part of this agreement, gym rules, or VIRTUS Centre policies
- Engages in conduct that is unsafe, harmful, or disrespectful to others
VIRTUS Centre | seb@virtuscentre.com.au | info@virtuscentre.com.au | Confidential Member Agreement

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM
$59.99/session | Session Payments via Square
- Is suspected of engaging in illegal activity on the premises
SECTION 8 — MEMBERSHIP PAUSE POLICY
Members may request to pause their Emerging Athlete Program membership under the following conditions:
- Pause requests must be submitted in writing via email to VIRTUS Centre.
- To be eligible for a pause, the account must be in good standing with all fees paid and up to date at the time of the request.
- This holding fee secures the athlete's place in the program.
- The maximum pause period is 3 months.
- The standard weekly membership fee of $49.99/week will resume automatically at the end of the nominated pause period.
- If you wish to return before the nominated pause end date, please notify VIRTUS Centre in writing and the full program will be reinstated promptly.
SECTION 9 — GYM ACCESS & SAFETY POLICY
Facility Access:
- Membership is non-transferable. Only the athlete named in this agreement may use this membership.
- Athletes must not share access, fobs, or entry codes with any other person.
- VIRTUS Centre reserves the right to revoke access at any time for safety or policy breaches.
Conduct & Safety:
- All athletes must always follow the direction of VIRTUS Centre coaches and staff.
- No bullying, harassment, or unsafe behaviour will be tolerated.
- Athletes must not use equipment without appropriate instruction.
- VIRTUS Centre is not responsible for personal belongings.
- Athletes must report any injuries, incidents, or unsafe conditions to a coach immediately.
VIRTUS Centre | seb@virtuscentre.com.au | info@virtuscentre.com.au | Confidential Member Agreement

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM
$59.99/session | Session Payments via Square
Equipment Damage:
- Any damage to VIRTUS Centre equipment or property caused by negligence or misuse
  may result in the member being charged for repair or replacement costs.
SECTION 10 — PARENT / GUARDIAN CONSENT
As the Emerging Athlete Program is designed for youth athletes aged 10–17 years, parent or guardian consent is required before any athlete may commence training.
By completing this section, the parent or guardian confirms that:
- To the best of their knowledge, all information provided in this form is correct
- They will inform VIRTUS Centre immediately of any changes to the athlete's health, medical, or personal details
- They consent to their child/ward participating in the Emerging Athlete Program at VIRTUS Centre and accept all terms and conditions outlined in this agreement
- They consent to VIRTUS Centre staff administering basic first aid in the event of an emergency, and to emergency services being contacted if required.
- They understand and agree to all payment, pause, cancellation, and no-show policies outlined in this agreement
Parent / Guardian Full Name
Relationship to Athlete
Parent / Guardian Mobile
Format: (000) 000-0000.
Parent / Guardian Email
example@example.com
Date

MonthDayYear
SECTION 11 — DIGITAL SIGNATURE & DECLARATION
By completing and submitting this form, you confirm that
- All information provided is truthful and accurate
- You have read, understood, and agreed to all VIRTUS Centre policies, waivers, and terms outlined in this agreement.
- This form constitutes a legally binding agreement between you, your parent/guardian (if applicable), and VIRTUS Centre
- All policies are binding from the date of your first payment
VIRTUS Centre | seb@virtuscentre.com.au | info@virtuscentre.com.au | Confidential Member Agreement

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM
$59.99 / session | Session Payments via Square
For any questions about this agreement please contact VIRTUS Centre before submitting.
Athlete Full Name (Digital Signature)
Today's Date

MonthDayYear
Date
VIRTUS Centre | seb@virtuscentre.com.au | info@virtuscentre.com.au | Confidential Member Agreement
Should be Empty:

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM

SECTION 1 — PERSONAL DETAILS

SECTION 2 — PRE-EXERCISE HEALTH SCREEN (PSS-YP V1 2021)

EMERGING ATHLETE PROGRAM -SINGLE SESSION SIGN-UP & AGREEMENT FORM

Young Person Acknowledgement (16-17 years):

SECTION 3 — MEMBERSHIP ACKNOWLEDGEMENT

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM

Program Inclusions:

SECTION 4 — LIABILITY WAIVER & MEDIA CONSENT

Physical Condition Declaration:

Risk Warming & Liability Waiver:

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM

SECTION 5 — PAYMENT TERMS & FAILED PAYMENTS

SECTION 6 — COOLING OFF PERIOD

SECTION 7 — CANCELLATION & NO-SHOW POLICY

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM

SECTION 8 — MEMBERSHIP PAUSE POLICY

SECTION 9 — GYM ACCESS & SAFETY POLICY

EMERGING ATHLETE PROGRAM — SINGLE SESSION SIGN-UP & AGREEMENT FORM

SECTION 10 — PARENT / GUARDIAN CONSENT

SECTION 11 — DIGITAL SIGNATURE & DECLARATION