Bounce Gymnastics Online Registration

Registration

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Welcome to Bounce Gymnastics! Please complete the following registration form. If you already have attended Bounce Gymnastics please click on 'ALREADY A MEMBER' and sign into your account rather than creating a whole new one. You will be asked to supply your account details so your fortnightly direct debits can be processed.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

General Information

Child's Surname Last Name*

Where do you live?

Home Address*

City*

State*

Post Code*

Primary Phone*

Additional Info

Extra Emergency Contact Number in case we cannot get in get to Contact #1 or #2*

Health Insurance Carrier - In case of emergency

Alternate Pick Up Person

Contact #1

Contact #1 First Name*

Last Name *

Relationship to Child*

How Can We Contact You?

Home Phone *

Work #

Cell #

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Relationship to child

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School

Any Previous Injuries

I permit BounceGymnastics to use photos/videos of my child/ren for social media/promotional purposes*

Special Conditions/Special Needs for example: ADHD, Asthma, Headaches, etc or N/A*

Allergies we need to be aware of. (write NIL if not applicable)*

Medications we need to know about (write NIL if not applicable)

Photo/Videos Allowed?*

Please note classes labelled Waitlist means you will need to wait for an opening before the staff will contact you for enrolment

Enroll in Classes

Select Another Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School

Any Previous Injuries

I permit BounceGymnastics to use photos/videos of my child/ren for social media/promotional purposes*

Special Conditions/Special Needs for example: ADHD, Asthma, Headaches, etc or N/A*

Allergies we need to be aware of. (write NIL if not applicable)*

Medications we need to know about (write NIL if not applicable)

Photo/Videos Allowed?*

Please note classes labelled Waitlist means you will need to wait for an opening before the staff will contact you for enrolment

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School

Any Previous Injuries

I permit BounceGymnastics to use photos/videos of my child/ren for social media/promotional purposes*

Special Conditions/Special Needs for example: ADHD, Asthma, Headaches, etc or N/A*

Allergies we need to be aware of. (write NIL if not applicable)*

Medications we need to know about (write NIL if not applicable)

Photo/Videos Allowed?*

Please note classes labelled Waitlist means you will need to wait for an opening before the staff will contact you for enrolment

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School

Any Previous Injuries

I permit BounceGymnastics to use photos/videos of my child/ren for social media/promotional purposes*

Special Conditions/Special Needs for example: ADHD, Asthma, Headaches, etc or N/A*

Allergies we need to be aware of. (write NIL if not applicable)*

Medications we need to know about (write NIL if not applicable)

Photo/Videos Allowed?*

Please note classes labelled Waitlist means you will need to wait for an opening before the staff will contact you for enrolment

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

School

Any Previous Injuries

I permit BounceGymnastics to use photos/videos of my child/ren for social media/promotional purposes*

Special Conditions/Special Needs for example: ADHD, Asthma, Headaches, etc or N/A*

Allergies we need to be aware of. (write NIL if not applicable)*

Medications we need to know about (write NIL if not applicable)

Photo/Videos Allowed?*

Please note classes labelled Waitlist means you will need to wait for an opening before the staff will contact you for enrolment

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

City

State

Post Code

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank State Branch (BSB) Number (6-digit number)

Account Number

Registration

Referral Information

General Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

eCheck/Bank Draft

Required Policies

(Show-Hide Details)