Open Squad Enrolment Form – Flipz Academy

Athlete Name *

First

Last

Athlete Birthdate *

M/F: *

Has the athlete visited SPC before? *

Parent/Guardian 1 Name *

First

Last

Parent/Guardian 2 Name

First

Last

Contact Phone *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Contact Email *

Emergency Phone number *

For transfer and insurance reasons, has the participant been enrolled in any previous Gymnastics Club? If Yes, Please specify below:

Has the athlete's medical information changed since your last visit to SPC? (medications, allergies, etc.) *

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

Select the Gymsport(s) you would like to enrol for:

WAG (Women's Artistic Gymnastics)
MAG (Men's Artistic Gymnastics)
Trampoline Sports (Trampoline, Tumbling, Double-Mini)
FreeG (Parkour, Free-running, Tricking)
Cheerleading

Please choose your WAG Open Squad class times below:

WAG, Monday

4:45pm - 6:45pm (2 hours)
5:00pm - 7:00pm (2 hours)
4:45pm - 7:45pm (3 hours)

WAG, Tuesday

4:45pm - 6:45pm (2 hours)
4:45pm - 7:45pm (3 hours)

WAG, Wednesday

4:45pm-6:45pm (2 hours)

WAG, Thursday

4:45pm - 6:45pm (2 hours)
4:45pm - 7:45pm (3 hours)

WAG, Friday

5:00pm - 7:00pm (2 hours)
4:45pm - 7:45pm (3 hours)

WAG, Saturday

11:30am - 1:30pm (2 hours)
9:30am - 12:30pm (3 hours)

Please choose your MAG Open Squad class times below:

MAG, Monday

4:45pm - 6:45pm (2 hours)

MAG, Tuesday

4:45pm - 6:45pm (2 hours)

MAG, Wednesday

4:45pm - 6:45pm (2 hours)

MAG, Thursday

4:45pm - 6:45pm (2 hours)

MAG, Saturday

9:30am - 11:30am (2 hours)

Please choose your Trampoline/Tumbling Open Squad class times below:

TRP, Tuesday

3:45pm - 5:45pm (2 hours)

TRP, Wednesday

4:45pm - 7:45pm (3 hours)

Please choose your FreeG Open Squad class times below:

FreeG, Monday

5:45pm - 7:45pm (2 hours)

FreeG, Friday

5:45pm - 7:45pm (2 hours)

Please choose your Cheer Open Squad class times below:

Cheer, Wednesday

4:45pm - 6:45pm (2 hours)

First day of class:

Total weekly (AUD) based on your selection

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 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

By signing this form, I accept SPC Policies: *

I accept

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&Conditions

I agree to SPC Terms&Conditions *

I agree

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

Parent/Guardian Signature *

Your expectations are important to us in delivering a quality service. What do you hope your child will gain through our programs?

How did you hear about us? *

Payment Details

Choose a method of payment for the selected classes *

Professional Payment Systems Australia (PPS)

ID #125844

PO Box 4270 Bundaberg, QLD 4670

Phone: 1300 36 35 38 Fax: 07 4151 7475

E-mail: customerservice@ppsbilling.com

Choose Direct Debit Payment Period *

Direct Debit Amount (AUD)

Direct Debit Amount - Weekly

Your Credit Card will be charged weekly with first instalment charged with submission of this form

Payment starts 1 week after your "First day of class". This is the day of the week your regular Direct Debit payments will be processed on.

Payment starts 1 week after your "First day of class". This is the day of the two-weeks period your regular Direct Debit payments will be processed on.

Payment starts 1 week after your "First day of class". This is the day of the monthly period your regular Direct Debit payments will be processed on.

Direct Debit Start Date *

Payer's Name *

First

Last

Payer's Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Payer's Phone *

Payer's Email *

By signing this, I (the Payer) promise to pay the amount budgeted UNTIL FURTHER NOTICE, equalling to "Direct Debit Amount" above (including GST). The first instalment being due on "Direct Debit Start Date" and all subsequent instalments on the same day of each consecutive week/fortnight to be paid directly to Professional Payment System Australia (PPS) for MINIMUM TERM OF 6 MONTHS and further, until advised to cancel. *

I accept

By signing this, I (the Payer) promise to pay the amount budgeted UNTIL FURTHER NOTICE, equalling to "Direct Debit Amount" above (including GST). The first instalment being paid with submission of this form and all subsequent instalments on the same day of each consecutive week to be paid directly to Super Performance Centre Pty Ltd for MINIMUM TERM OF 6 MONTHS and further, until advised to cancel. *

I accept

6 Months Pre-paid amount (AUD)

12 Months Pre-paid amount (AUD)

20% Off Discount applied

PAYMENT POLICIES:

LATE PAYMENT POLICY: A $10.00 service fee is applied to ‘returned’ payments and on any payment received 10 days past due date, this is additional to the dishonour fee from your respective banks. A $7.50 late fee is incurred on any past due date payment periodically every 10 days. Additional late charges occur at 30 days intervals.
MINIMUM TERM A minimum term of 6 months is applied to all memberships and is determined from the date of purchase. All memberships will be charged to the customer based on the option selected. Once you have completed your minimum term, your membership will automatically roll over to the next term. If you wish to opt out (once you have completed your minimum term), you are able to do so in writing by email to memberships@SuperPerformanceCentre.com.au Notice of opt out must be in writing and it must be provided with at least 14 day notice before the next debit to guarantee cancellation prior to the payment.
I understand that ignorance or absenteeism to the scheduled classes will not void this agreement nor entitle myself to a credit. You can cancel your membership during the minimum term without penalty if: Participant is sick or incapacitated. A certificate from a qualified medical practitioner must be presented stating that a member cannot exercise for the rest of 6 month term, OR you are bankrupt. Supporting documents must be presented in this instance. In all other cases, an early exit fee of $150, and 14 days-notice will be required to cancel a membership within the minimum term.
UPGRADES/DOWNGRADES Members may upgrade their membership at any time during the term of their membership with no penalty or fees. Members may not downgrade their membership during the minimum term.
SUSPENSION (FREEZE MEMBERSHIP) You can suspend your membership for 2 or more weeks, up to a maximum of 6 weeks at a time. You cannot suspend your membership for a partial week. The suspension fee for all memberships is $10 per week, which you can pay in advance or by direct debit. Memberships can only be suspended when all membership fees are up to date and no money is outstanding. SPC CENTRE cannot backdate any suspension. Please note that if you are within your minimum term, membership suspension is not classified as a payment towards your contracted term. You can suspend your membership for more than 6 weeks if you have travel, medical or bankruptcy reasons. SPC CENTRE Management must be satisfied by your supporting documents to suspend your membership for longer than 6 weeks. SPC CENTRE will not charge you for membership suspension if you suspended your membership due to health or bankruptcy reasons.
I understand that upon cancellation of this agreement, a notice period of 14 Days must be given to the club in writing to memberships@superperformancecentre.com.au, before the agreement will be cancelled.

PAYMENT POLICIES:

I understand that enrolment is not guaranteed after the finish date and this amount is strictly Non-refundable.
MINIMUM TERM A minimum term of 6 months is applied to all memberships and is determined from the date of purchase. All memberships will be charged to the customer based on the option selected. Once you have completed your minimum term, your membership will NOT automatically renew beyond the 6 or 12 months contract. SPC will contact you prior to your membership expiring to see if you would like to renew your membership.
I understand that ignorance or absenteeism to the scheduled classes will not void this agreement nor entitle myself to a credit. You can cancel your membership during the minimum term without penalty if: Participant is sick or incapacitated. A certificate from a qualified medical practitioner must be presented stating that a member cannot exercise for the rest of this term, OR you are bankrupt. Supporting documents must be presented in this instance.

In all other cases, an early exit fee of $150, and 14 days-notice will be required to cancel a membership within the minimum term.
UPGRADES/DOWNGRADES Members may upgrade their membership at any time during the term of their membership with no penalty or fees. Members may not downgrade their membership during the minimum term.
SUSPENSION (FREEZE MEMBERSHIP) You can suspend your membership for 2 or more weeks, up to a maximum of 6 weeks at a time. You cannot suspend your membership for a partial week. The suspension fee for all memberships is $10 per week, which you can pay in advance or by direct debit. Memberships can only be suspended when all membership fees are up to date and no money is outstanding. SPC CENTRE cannot backdate any suspension. Please note that if you are within your minimum term, membership suspension is not classified as a payment towards your contracted term. You can suspend your membership for more than 6 weeks if you have travel, medical or bankruptcy reasons. SPC CENTRE Management must be satisfied by your supporting documents to suspend your membership for longer than 6 weeks. SPC CENTRE will not charge you for membership suspension if you suspended your membership due to health or bankruptcy reasons.

Please initial to confirm accepting PAYMENT POLICIES *

Payer's Initials

Bank Name *

Account Name *

BSB *

Account Number *

Payer's Signature *

Class Registration fee applies to all new SPC members. It covers the athlete's registration for 12 months since the first day of class.

Class Registration fee

Price: $ 155.00

I agree that Class Registration fee of $155 is NOT refundable *

I agree

Class Registration fee covers 12 months from the first day of class enrolment.

Would you like to add extra insurance? *

Extra insurance covers anything not covered by Medicare

Extra Insurance

Price: $ 40.00

Would you like to add extra insurance? *

Extra insurance covers anything not covered by Medicare. Extra insurance of $0.80 will be included in your weekly fees if you choose "Yes".

Total

$ 0.00

Credit Card Number, Expiry Date and CCV number *

Card

Name on Card

SPC