Student Details

First Name

Last Name

Date of Birth

age as at 31/8/12

Parent/Guardian's name (for students 3-16 yrs)

Contact Details

Address

Suburb

Postcode

Phone Number

Mobile Number

Email address

Emergency Contact Name

Emergency Contact Number

Other Details

Allergies/Ilness/Disorders

Current medication (if any)

School Currently Attending

Classes to be attended

Monday Classes
 Littlies (3-4yrs) – 3:30pm 5-6yrs – 4:00pm 7-8yrs – 4:45pm 9-12yrs – 5:30pm 13-16yrs – 6:45pm Ladies – 7.45pm

Saturday Classes
 Littlies – 9:00am Ladies – 9:30am 5-6yrs – 11:00am 7-8yrs L1 – 11:45am 7-8yrs L2 – 12.30pm (invitation only) 9-12yrs – 1:15pm 13-16yrs – 2:15pm

Other details

Are you interested in competitions (5yrs+)?
 Yes No

Are you interested in teams?
 Yes No

Where did you hear about NSP?
 Word of mouth Newsletter Noticeboard Flyer Website Other

Do you give permission for photos of this student to be used on NSP’s advertising material including our website?
 Yes No

In the case of an emergency, do you give permission for our teachers to call 000, and perform first aid on this student if the situation requires it, and agree to incur the costs of that service?
 Yes No

Terms

I agree to check the website every fortnight