• If registering more than one person, please enter the name of the lead member first.

• * = Mandatory * Select After School Club Registration Champions Club GBP 44.00 Gymnastics Club - Club Annual Fee - On Target Multisports GBP 10.00

• Halfway Houses PS - KS1 Gymnastic Club - Term 3Cost £18.00

• Halfway Houses PS - KS1 Gymnastic Club - Term 5Cost £15.00

• Fridays After School - Term 4 Halfway Gymnastics Club - Year 1 & 2 - Term 4Cost £18.00

• Tuesdays After School Year 1 & 2 Multisports Club 30th April - 9th July St Peters Primary School - KS1 Multisports Club - Term 5 & 6Cost £30.00

• Tuesdays After School Year 1 & 2 Multisports Club 15th January - 26th March St Peters Primary School - KS1 Multisports Club - Term 3 & 4Cost £30.00

• Champions ClubCost £44.00

• --QTY--12345 OTM Kit - On Target Multisports Cost £35.00

• MEMBER DETAILS

• First name*

• Last name

• Gender Select Male Female

• Date of birthDay12345678910111213141516171819202122232425262728293031MonthJanFebMarAprMayJunJulAugSepOctNovDecYear20242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924
• Age

• School / College attended

• Please detail any medical information, allergies or injuries that the club should be aware of

• PARENT / GUARDIAN SECTION

• Parent / Guardian first name

• Parent / Guardian last name

• Home phone number

• Mobile phone number

• Email address*
• Verify email address*

• Please give additional contact information below (in case of emergency)

• DECLARATIONS

• In the event that the above named member is injured whilst in the care of the club: Select I give consent for medical treatment to be administered I do not give consent for medical treatment to be administered

• Photographic Consent
  
  Images of members under the age of 18 will never be identified or named without parental consent and will only be used in accordance with the Clubs child protection/photography policies and Best Practice guidelines.

• Photographic consent Select I consent I do not consent

• I will abide by the Club's constitution, club rules, code of conduct, disciplinary policy, equity policy, social networking and child welfare policy. I understand that if the above named member does not also abide by these rules / codes of conduct / policies that the club may take disciplinary action. Select I agree I disagree