Parent/Guardian Details Pre School Registration Form 2011/2012 Membership Number P11/.................... Membership fees FREE Child’s Details Name: Surname: Date of birth: Class: Name: Address: Contact details; Parent/Guardian Details Post code: Home: Mobile: E-mail: Emergency In case of emergency please list an alternative contact should be unable to reach you Emergency contact: Relationship: Please advise if your child suffer from any of the following: Asthma Eczema Migraine Hayfever Epilepsy Allergic to plasters – Yes No Please give details of any other medical condition we should be aware of; Medical details: Zippy’s Gymnastics Academy occasionally takes photographs for promotional use. If you do not wish your Child to be included, please include a letter to this effect with the application form. Zippy’s gymnastics Academy is committed to conducting its activities in the safest manner possible. We hold the safety of the participants in the highest possible regard. Parents must recognize however that there is an inherent risk of injury Parents must be responsible for children under 3’s. Children are not allowed to climb or play on any apparatus other than under the direction of the coach. POLICY AGREEMENT

  I understand that my payment is due on the first week of every month. I understand that if my payment is late that a late charge of £5 I understand if I need to drop my child from classes, I must notify the office before the first week of the new month or I may be charged for the entire month. I understand there are no refunds. I must call to schedule a make-up opportunity during the current session. Please see detailed policies for further information. I must be currently enrolled to participate in a make-up class. POLICY AGREEMENT All gymnasts should arrive at the gym no less than 5 minutes before their class. Hair must be neatly tied back. No shoes or boots permitted in the gym. Female gymnasts are asked to wear a Leotard. Male gymnasts are asked to wear shorts and a t-shirt or leotard SIGNED _____________________________ DATE__________________ 30 minute class Fun for baby £18 a Month £4 trial 45 minutes class age 1- 5 year £19.50 Standing Order per month £22 Cash/ Cheque per month £5 a trial Monthly Rate