PLEASE NOTE Current class registration is required to enrol in casual classes. If it has not been paid, an invoice will be sent. BOOK A CLASS BELOW Please enable JavaScript in your browser to complete this form. Select the class you would like to book: *Kindy Gym - Parent Assisted Please select age group: *Please selectWalkers - 3.5 years3.5-5 yearsKindy Gym Parent Assisted (Walkers - 3.5 years): *Please select class day and timeTuesday 9:30am-10:30am (1 hour)Wednesday 9:30am-10:30am (1 hour)Saturday 8:00am-9:00am (1 hour)Kindy Gym Parent Assisted (3.5-5 years): *Please select class day and timeTuesday 10:30am-11:30am (1 hour)Wednesday 10:30am-11:30am (1 hour)Saturday 8:30am-9:30am (1 hour)Select Date for this class: *Please select dateFirst ChoiceSecond ChoiceThird ChoiceCasual class priceHas the athlete been enrolled into SPC class before? *Please selectYesNoDoes the athlete have current Class Registration paid? *Please selectYesNoPlease note: if no current class registration has been paid, an invoice will be sent.Athlete Name *FirstLastBirthdate *DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920M/F: *Please selectMaleFemaleParent/Guardian 1 Name *FirstLastParent/Guardian 2 NameFirstLastPhone *Address *Address Line 1CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryEmail *Emergency Phone number *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 classIs the athlete on any medication we should be aware of? Please specify:I consent for SPC to keep a record of my/my child's medical information: *I confirmDoes the athlete suffer from any allergies (ie medical, bee sting, food, etc)? Please specify:SPC Policies: 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 give permission for my child to receive medical/ambulance assistance in case of emergency and agree to pay such costs. I understand that I may access my child's personal information held by the Centre upon request I understand no more than 2(two) trials can be booked in the same class. After the second trial formal registration with SPC is required I understand a formal registration policy is recorded and is available upon request All classes continue during School Holidays, excluding Public Holidays All members must register for Trampoline sessions and wear wrist band and grip socks during their session SPC has strictly NO REFUND policy. All bookings are non-refundable. We are not required to provide a refund, credit or transfer if you change your mind. Please visit SPC Terms and Conditions for more information. By signing this form, I accept SPC Policies: *I acceptThe 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 confirmYour expectations are important to us in delivering a quality service. What do you hope your child will gain through our programs?Consent form/Indemnity: 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). Please follow the link to read: SPC Terms&ConditionsI agree to SPC Terms&Conditions *I agreehttps://www.superperformancecentre.com.au/terms-and-conditions/I agree that the casual class fee is NOT refundable and scheduled class day and time can be changed ONLY with at least 48 hour notice period *I agreeSignature *Clear SignatureClass Registration feePrice: $ 170.00Valid for full calendar year, from the date of purchaseTotal *$ 0.00Credit Card Number, Expiry Date and CCV number *CardName on CardThis form was filled usingEmailSubmit