Ballina RSL Youth Club
GYMNASTICS REGISTRATION FORM 2017
Gymnast’s Details
Surname(s): _________________________ First Name: ________________________
Middle Name: _____________________ Gender: male female 
Date of Birth: _____/_____/____________ Age: _______
Home Address:
__________________________________________________________
Suburb: _______________________________ Postcode: ________________
To help us meet your child’s needs, please specify any disabilities, weaknesses/previous
injuries or allergies and first aid required. (Please state symptoms and treatment for your child on the lines
below).
______________________________________________________________________
______________________________________________________________________
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Contact Details
Contact #1 Name:______________________ Relation to gymnast: _____________
Mobile Number: ________________ Email Address: _____________________________
(Your email address will be used to send invoices/receipts & some club correspondence. Please add us to your address book
& check your email regularly)
Contact #2 Name: ________________________ Relation to gymnast: _______________
Mobile Number: ________________ Email Address: _____________________________
(Your email address will be used to send invoices/receipts & some club correspondence. Please add us to your address book
& check your email regularly)
Postal Address: ____________________________________________
Suburb: ___________________________________ Postcode: ___________
Emergency Contact other than parents/contacts list above (for use only if we cannot contact parents)
Name: ___________________________
Relation to gymnast: __________________ Phone number:___________________
Previous Gymnastics Experience/Membership
Yes, at Ballina RSL Youth Club 
Yes, at another gymnastics club.
Previous gymnastics club: _________________
No, but other members of our family are currently enrolled in gymnastics classes or
have previously participated in gymnastics classes at Ballina RSL Youth Club 
None, no member of our family has done gymnastics at Ballina RSL Youth Club 
~ PLEASE TURN OVER ~
Uniform
All gymnasts must wear appropriate clothing e.g. T-shirt, shorts, Leotard and tight fitting
clothing while participating in gymnastics classes at Ballina RSL Youth Club.
Hair is to be tied up and worn away from the face at all times.
No Jewellery is to be worn on the gymnastics equipment at any time.
All Competitive gymnasts are required to purchase club leotards and tracksuits for
competitions.
Authority & Acknowledgement of conditions
By signing below I confirm and agree to the following

I agree to becoming an Ordinary Member or Associate Member of the Ballina RSL
Youth Club and I agree to the above named gymnast attending Ballina RSL Youth
Club.

I have read and understand Ballina RSL Youth Club’s Rules & Policies (available on
the club’s website & in print form at the club) and agree to the terms and conditions
stated therein.

I give consent to the Ballina RSL Youth Club to take action in an emergency E.g.
First aid, Ambulance etc. If they’re unable to contact the parents/guardians given, in
relation to an injury.

The information on this form is complete and correct to the best of my knowledge and
I agree to advise Ballina RSL Youth Club promptly of any changes that may occur.

I give permission for the gymnast to be photographed/videoed while participating in
activities at Ballina RSL Youth club or at representative activities and I consent for
these photos/videos to be used for publicity if required, in both print and electronic
form. Note: if you do not wish the gymnast to be photographed/videoed you need to
inform Jade or Kim at the front office.
Signed (Parent/Guardian) _____________________________ Date_____________
Name (Please Print) _________________________________
OFFICE USE ONLY
Student I.D. # _______________________ (G.O.L) Entered: ____________________ _
Registration Fees Paid: YES/NO
Amount & Mode __________________
Date:________
Receipt #: ___________________________ SIGNED: _________________________
Gymnastics class type: REC LEVELS GYM SKILLS KINDY OTHER: _____________