that in the event of injury or illness, whilst in attendance at Gogo training, i give
my permission for a representative of Gogo to make decisions on my child's ...
1300 482 209 www.gogohealthykids.com.au
Child 1
First Name*: ......................................................................... Family Name*: ...................................................................... Date of Birth*: ..... /..... /..... School*: ................................................................................ ............................................................................................. Medical Conditions / Allergies*: ............................................................................................. .............................................................................................
- All GoGo Kids are encouraged to bring a water bottle. Water will be provided. - GoGo Kids will be responsible for their own belongings GoGo Healthy Kids will not be responsible for lost property. - Registration forms must be completed and signed prior to commencement of training sessions for safety and insurance purposes. Once signed, this form will be considered as written consent by the parent/guardian for continued training sessions until otherwise notifed. - Payment must be received at the beginning of each session.
Easy enrolment and payment options
1. Fill out form and post to 22 walker avenue Edgecliff, NSW 2027 or scan it in and email it back to us at:
[email protected]
Child 2
First Name: ........................................................................... Family Name: ........................................................................ Date of Birth: ..... /..... /..... School : ................................................................................ ............................................................................................. Medical Conditions / Allergies : ............................................................................................. .............................................................................................
2. Payment by cheque, direct deposit or credit card. - Cheque made out to : GoGo Healthy Kids Pty Ltd and Mail to : 22 walker avenue Edgecliff NSW 2027 Please write your child’s full name on the back of your cheque.
- Direct Deposit: Account GoGo Healthy Kids Pty Ltd BSB: 032 040 AC# 221 533 Please use your child’s full name as your payment reference
- Paypal: Use your credit card or paypal funds. We will email you an invoice with a direct link through to our paypal options.
Morning:
POSSIBLE
Mon 23rd
$30
$30
Afternoon:
$30
$30
$30
All Day:
$50
$50
$50
12Pm/3Pm 9Am/3Pm
Total Days: Parent / Guardian
Total Half Days:
Full Name*: ................................................................. Home Phone*: ............................................................. Mobile Phone*: ............................................................ Address*: ................................................................... ..................................................................................
Wed 25th
$30
9Am/12Pm
Early drop off : 8h30 (Free) Late pick up : 4pm ($10)
Tues 24th
Total Late Pick Up:
PRICE:
Relationship to Child*: ................................................. .................................................................................. Work Phone*: .............................................................. Email*: .......................................................................
I ............................................................................. understand that there exists an element of risk when my child is undertaking any exercise program or sporting activity such as Gogo. I Also acknowledge that the Gogo staff will do the best of their ability to monitor and care for the well-being and safety of my child. I acknowledge that there exists no reason as to why my child should not exercise and also understand and agree that in the event of injury or illness, whilst in attendance at Gogo training, i give my permission for a representative of Gogo to make decisions on my child’s behalf concerning the most appropriate action to be taken with respect to my child’s condition. In signing this form, i affirm that i have read it entirely and that all my questions regarding the proposed exercise programs have been answered to my satisfaction. My child’s participation is totally voluntary. I agreeto assume the risk of such exercise for my child and further agree to hold harmless Gogo or its subsidiaries, afiliate, employees, agents and any other persons associated from any and all claims, suits, losses, or related causes of action for damages including, but not limited to, such claims that they may result from injury or death, accidental or otherwise arising in any way from the exercise regime.
Signed:
Full Name: ........................................................
Date: ..... /..... /.....
