Recreational 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 2020-21 of Arabesque Rhythmics.

Please check the the correct Team level *

Team - 2.5 hours/week (online, in-the-gym), Wednesdays

Team practises (all streams) run from September 2019 to June 2020.

Waiver (only applies to online practises). COVID in-the-gym waivers are posted on the club website (registration page). *

I state that I will not hold responsible Clymont Community Hall, Arabesque Rhythmics, or its coaches for any personal injuries or property loss or damage suffered by my child while participating in Arabesque Rhythmics classes (online or in-the-gym) 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)

Amount to be paid

In-the-gym training (2.5 hrs/week) $120.00/month Oct-June Online training (1 hour/week) $45.00 (September) RGA registration fee $60.00 (due in September)

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 Athlete Registration Form 2020-21