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2024 Wynnum Manly Physie Registration
Complete the form below to register with Wynnum Manly for 2024. For any questions, please email wynnummanlyphysie@outlook.com
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* Indicates required question
Email
*
Your email
Secondary Email (if required)
Your answer
Student Name Full Name
*
Your answer
Parent/Guardian Full Name (N/A if over 18)
*
Your answer
Main Contact Number
*
Your answer
Student Birthday
*
MM
/
DD
/
YYYY
Age on August 31st (competing in that age group for 2024)
*
3 Years
4 Years
5 Years
6 Years
7 Years
8 Years
9 Years
10 Years
11 Years
12 Years
13 Years
14 Years
15 Years
1st Years
2nd Years
Novice Seniors
Open Seniors 19-20
Opens Seniors 21-22
Open Seniors 23-24
Open Seniors 25-27
Open Seniors 28s and Over
Beginner Ladies
Novice Ladies
Intermediate Ladies
Under 33 Ladies
Over 33 Ladies
Over 40 Ladies
Over 50 Ladies
Over 60 Ladies
Over 70 Ladies
Student Age Group
*
3-4 Years
5-6 Years
7-8 Years
9-10 Years
11-12 Years
13-1st Years
2nd Year/Novice Seniors
Open Seniors
Beginner/Novice/Intermediate Ladies
Open Ladies
Choose the two days you will be attending class (fees are based on 2 lessons a week)
*
Tuesday (5 to Ladies)
Wednesday (Ladies only)
Thursday (5 to Ladies)
Saturday (3 - 8 years)
Required
Please select payment plan
*
Pay in full
Pay in 3 instalments
Please choose any relevant allergies or medical conditions below:
*
N/A
Egg Allergy
Nut Allergy
Dairy Allergy
Asthma
Anxiety
Injury or Physical Condition
Other:
Required
Are there any custody issues?
*
Yes
No
Other:
Do you give Wynnum Manly Physie permission to use your child's photo for advertising on social media? (No names or private information will be used)
*
Yes
No
Please select how many years you have been doing physie with Wynnum Manly.
*
NEW Member
1-5 Years
6-10 Years
11-15 Years
15 + Years
A copy of your responses will be emailed to the address you provided.
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