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2022 Club Registration
Kedron Park Physical Culture Club 2022 Registration.
Parent/Guardian to fill out the form if participant is under the age of 18.
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* Required
Members Name
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Your answer
Members Date of Birth
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Your answer
Age (as of 31st August 2022)
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Your answer
Email
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Your answer
Contact Number
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Your answer
Member Address
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Your answer
How will you be paying fees?
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Upfront Lump Sum
3 Term Instalments
Pre-arranged Payment Plan
Pre-Existing Medical Condition
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Your answer
Emergency Contact Name
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Your answer
Emergency Contact Relation
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Your answer
Emergency Contact Phone Number
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Your answer
Previous Physie Experience?
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Yes
No
What club did you attend?
Your answer
What age group did you last compete in?
Your answer
Do you have Facebook?
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Yes
No
Do you give us permission to use photos for social media and advertising?
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Yes
No
Do you give us permission to use videos and photos on tiktok?
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Yes
No
I will abide by the BJP Code of Conduct (can be found in the welcome pack)?
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Yes
No
What is your occupation?
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Your answer
How did you hear about us?
Your answer
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