2020 Enrollment Form

2020 General Enrolment Form
Super Performance Centre
Southport Park Shopping Centre

Corner of Ferry Rd and Benowa Rd

Southport, QLD 4215

Inside the Shopping Centre, next to Coles
This enrollment form is for Trampoline and Ninja Action Zone access and optional SPC classes(can be selected below).

If you would like to enrol multiple athletes, please fill-in a separate form for each one individually.

For current prices and specials, please call us at 07 5532 8429 or see Front Desk at any time.
Athlete Name:*

First NameLast Name
Athlete Date of Birth*

DayMonthYear
M/F:*
Parent/Guardian 1 Name:*

First NameLast Name
Parent/Guardian 2 Name:

First NameLast Name
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
Emergency Phone Number*
For transfer and insurance reasons, has the participant been enrolled in any previous Gymnastics Club? If Yes, Please specify below:
Athlete's medical history
Please provide details of any medical, physical or intellectual condition that may have a bearing on your child's ability, safety or behaviour in class
Is your child on any medication we should be aware of? Please specify:
Does your child suffer from any allergies (ie medical, bee sting, food, etc)? Please specify:
I consent for SPC to keep a record of my/my child's medical information:*

I confirm

CLASS/CLASSES Selection
PLEASE NOTE: For an enrolment to be active, Annual Class Registration of $155 must be paid. It covers any amount of classes per week for the period of 1 year starting from the enrolment day of the first class.
Please visit:

SPC 2020 Time table for giudeline only (classes subject to availability)

and/or

Current Classes availability for up-to-date classes availability.

For current prices and specials, please call us at 07 5532 8429.
Please enter Preferred Class/Classes below (Optional) and click "Add more" button to enter multiple:
Please choose your start date:*

Please read through the following conditions carefully:
I give permission for images of my child to be acquired by a sanctioned videographer while participating in any club activities. I consent for the images to be used for publicity if required:*

I accept
I give permission for my child to receive medical/ambulance assistance in case of emergency and agree to pay such costs:*

I accept
I understand that I may access my child's personal information held by the Centre upon request:*

I accept
I understand a formal registration policy is recorded and is available upon request:*

I accept
All classes continue during School Holidays, excluding Public Holidays:*

I accept
All members must Register for Trampoline sessions and wear wrist band and grip socks during their session:*

I accept
SPC has strictly NO REFUND policy:*

I accept
The information provided in this form is complete and correct to the best of my knowledge and I undertake to advise the club promptly of any changes that may occur:*

I confirm
I have read and understand this enrollment application and agree to the terms and conditions stated therein:*

I confirm
How did you hear about us?:
Your expectations are important to us in delivering a quality service. What do you hope your child will gain through our programs?

Concent form/Idemnity:

By signing this, I fully understand the nature of Super Performance Centre's classes and activities and agree for my child/myself to participate at their own risk, knowing and accepting that Super Performance Centre will ensure that all activities are carried out in a safe and reasonable manner.

I agree and abide by any guidelines set out by Super Performance Centre and to follow the instructions given by coaches, teachers and/or Super Performance Centre staff. I also undertake to pay all medical costs, which may be incurred by me and by anyone as a result of my actions while participating in these activities.

I shall, on demand, indemnify and keep indemnified Super Performance Centre against all reasonable costs, charges, expenses, liabilities, outgoings and payments which Super Performance Centre pays or sustains in any way arising from any circumstance which may occur during my(the member) attendance at Super Performance Centre's program(s).
Today's date*

DayMonthYear
Date
Signature*
Classes Payment Method

Please choose your payment method and download the corresponding form or request a paper copy from SPC Front desk. Fill-in the form and bring it back to SPC Front desk or scan it and send to memberships@superperformancecentre.com.au. To Sumbit this form, please click the Submit button at the end.
Please make sure that you Initial and Sign on every field required.
I would like to pay for classes by:*

Direct DebitPre-Paid (By choosing this option, I agree that Pre-Paid amount is non-refundable once paid)
Direct Debit form:
Pre-Paid form:
Annual Class Registration*
prevnext( X )
2020 Class Registration$155.00AUD

Total $0.00AUD
Should be Empty:

2020 General Enrolment Form

Classes Payment Method