Gymsport Application Form

Class Application Form - Gymsport & Recreation Centre/Counties Manukau

We request the following information to aid us in accomodating applicants into programmes. Once a programme has been confirmed, a registration/application form will need to be completed at the Gymsport & Recreation Centre.





Parents / Caregivers (emergency)



Medical

We request the following information about your child to aid us in giving maximum care while in class. All information is confidential

Condition Yes / No Please provide details
Asthma Yes No
Epilepsy Yes No
Hearing Problems Yes No
Bone Injuries Yes No
Muscle Injuries Yes No
Heart Problems Yes No
Other Yes No

Declaration

I/we, the undersigned in making this application understand that participation in gymnastics/trampoline involves movement, rotation and height in a unique environment and as such carries with it a reasonable assumption of risk. I/we agree that the leaders and instructors of the Gymsport & Recreation Centre/Counties Manukau Gymnastics are free and clear of all responsibility for any accident in connection arising whilst at the Gymsport & Recreation Centre. I authorise the Gymsport & Recreation Centre/Counties Manukau Gymnastics that in the event of such accident or illness, to obtain such necessary medical or other assistance as is required, and agree to meet any expense attached thereto.

I further declare that:

  • my child is in good health and agree to advise the Centre immediately in the event of contracting any ailment likely or considered likely to be detrimental to the health of other class participants.
  • that he/she will comply with all reasonable instructions of staff members of the Gymsport & Recreation Centre.
  • that if he/she commit any act of misconduct that in the opinion of the Centre Manager is detrimental to the good name of the Centre of the Instructors, he/she will be liable to have his/her membership terminated or suspended
  • there will be no refunds for suspension or termination
  • I understand and accept the payment policy of the Gymsport & Recreation Centre

I acknowledge that I have read and accept the declaration above: