Recreational Registration Form

Arabesque Rhythmics Competitive Registration Form
Name *
Address *
City *
Postal Code *
Phone (home) *
Phone (cell) *
Email *
Including email address implies consent to receive information emailed from Arabesque Rhythmics
Birth date (yy/mm/dd) *
Parents' names *
Emergency Contact *
Emergency Phone *
Medical Considerations/ previous injuries
Club Policies *

I have read, understood and agree to uphold the Club Policies 2019-20 of Arabesque Rhythmics.
Please check the the correct Team level *

Team - Interclub 3.5 hours/week Team - Interclub 5.5 hours/week Team - Interclub 6-8 hours/week Team - Provincial stream 8+ hours/week Team - Regional stream 13 hours/week Team - National stream 16+ hours/week
Team practises (all streams) run from September 2019 to June 2020. Start and end dates will be slightly different for each group, please check the website for specific dates.
Waiver *

I state that I will not hold responsible Clymont Community Hall, Black Gold School Board, Arabesque Rhythmics, or its coaches for any personal injuries or property loss or damage suffered by my child while participating in Arabesque Rhythmics classes or associated activities.
Parent/Guardian Name *
Date *
Release

Athletes' image, likeness, name (excluding personal address, phone and email address) province, city/town and club as well as previous competitive or performance history may be used in publications and on the internet by Rhythmic Gymnastics Alberta and Arabesque Rhythmics as well as its agents and sponsors from time to time.
Parent/Guardian Name
Date
Please indicate method of payment *

Fees paid per month (10 post-dated cheques or e-transfer on the 1st of each month) Fees paid per session (3 post-dated cheques or e-transer on the 1st day of Sept, January and April)
Please indicate amount paid

Interclub (3.5 hrs/week) $115.50/month or $385/session + $60 RGA registration fee Interclub (5.5 hrs/week) $170.00/month or $566.67/session + $60 RGA reg fee Interclub (8 hrs/week) $200.00/month or $666.67/session + $60 RGA reg fee Provincial (10 hrs/week) $225.00/month or $750.00/session + $70 RG reg fee Provincial (13 hrs/week) $265/month or $883.33/session + $80 RGA reg fee Regional (13 hrs/week) $265/month or $883.33/session + $80 RGA reg fee National (16 hrs/week) set on individual basis + $90 RGA reg fee
Please note, PIPEDA forms must also be submitted to complete registration. If you submit registration online, you will need to fill out the PIPEDA form at the first class (forms will be provided by the club).

Cheques sent in advance of the first class are mailed to: Arabesque Rhythmics c/o #19 51306 RR 262, Spruce Grove, AB T7Y 1C4.
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Arabesque Rhythmics Competitive Registration Form