Toddler gym registration form

Use this form to register for Toddler Gym at Stirling Leisure Centres.

First name*

Last name*

Street address*

Suburb*

Postcode*

Daytime contact number*

Email*

First name*

Last name*

Date of birth*

Gender*

FemaleMale

Does the participant have any medical conditions?*

YesNo

Which centre would you like to book?*

What age group will you be registering for?*

6 months - 1 1/2 year
1 1/2 years - 2 1/2 years
2 1/2 years - 4 years

How did you hear about the program?*

Terms and conditions

Where a withdrawal from a class is requested, a credit or refund maybe issued upon presentation of a medical certificate
Please note that, refunds will incur an administration fee
I acknowledge that participation in Stirling Leisure Centres programs by myself, family members and/or my visitors is at our own risk
I also understand that no liability of personal injury, loss or damage to personal effects is accepted by Stirling Leisure Centres, the City of Stirling or its employees whilst attending this program
I have read and understood the Term and Conditions, and accept the policies of Stirling Leisure Centres.

I consent and accept to the terms and conditions

Retype the numbers below:


----