Enrol at ImpactAlpha.

To enrol in classes at ImpactAlpha please complete the following online registration form.

Enrolment Form

You will be contacted upon receiving a place in a class.

To enrol many attendees, complete this form once for each attendee.

Parent/Guardian Name:
Participant:
Phone number:
Gender:
Emergency phone number: (Phone/mobile number)
Email:
Date of Birth:
Address:
Programmes:
Preschool
1 hour Recreational
1 1/2 hour Recreational
Trampoline
2 hour gymsports
Comments: Please specify class and preferred day/time and a second choice:
  How did you hear about us?
  Are there any services that you as a parent/guardian could provide to improve our club?
Medical History
  Please provide details of any, physical or intellectual condition that may have a bearing on your childs ability, safety or behaviour in class:
  Is your child on any medication, which we should be aware of?
  Does your child suffer from any allergies, which we should be aware of?

Terms and Conditions:

  1. I understand that I am responsible for payment of any term fees and understand that if I fail to do so, I may be referred to a debt collection agency and will be responsible for any debt collection costs incurred.
  2. I give permission for my child to receive medical/ambulance assistance in case of emergency and agree to pay any costs incurred.
  3. I understand that I may access my childs personal information held by the club.
  4. I understand that this information may be shared with Gymsports NZ.
  5. I understand that a formal registration policy is recorded and is available upon request
  6. The information provided on 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
  7. I have read and understood this enrolment application and club rules and agree to the terms and conditions stated therein.
  8. I give permission for my child to be photographed/videoed while participating in any club activities and consent to these being used for publicity if required.

  I agree to these terms and conditions

 
You can also email us admin@chchgymnastics.co.nz or phone 388 6616 mentioning the ImpactAlpha venue.