Registration Form Email Student Name Parent/Guardian Contact Name Student Address Best Contact Email Address Best Contact Number Emergency Contact Name Emergency Contact Number Any known medical conditions, injuries or allergies? Student Birthday Student Age this Year (as of 31 August) Nights you wish to attend* Monday (Bardon) Tuesday (Deebing Heights) Both Which Classe/s do you wish to attend?* 5-8 ($139/term) 9-12s ($149/term) 13-1st Yrs ($149/term) Ladies ($149/term) Seniors ($149/term) Do you wish to pay in instalments (one invoice per term) or annually (5% discount) Instalment Annual I need another payment option. This will be discussed with us directly. Do you anticipate you/the student will compete? Yes No Maybe Do You Accept Our Terms & Conditions? I accept (https://www.cityphysie.com.au/terms-and-conditions/) Send
Email Student Name Parent/Guardian Contact Name Student Address Best Contact Email Address Best Contact Number Emergency Contact Name Emergency Contact Number Any known medical conditions, injuries or allergies? Student Birthday Student Age this Year (as of 31 August) Nights you wish to attend* Monday (Bardon) Tuesday (Deebing Heights) Both Which Classe/s do you wish to attend?* 5-8 ($139/term) 9-12s ($149/term) 13-1st Yrs ($149/term) Ladies ($149/term) Seniors ($149/term) Do you wish to pay in instalments (one invoice per term) or annually (5% discount) Instalment Annual I need another payment option. This will be discussed with us directly. Do you anticipate you/the student will compete? Yes No Maybe Do You Accept Our Terms & Conditions? I accept (https://www.cityphysie.com.au/terms-and-conditions/) Send
