2020 Club Membership Registration
Complete the form below to sign up for our membership service.
Athletes Mobile Number:
Athletes Birth Date:
Athletes Age as of Dec 31 2020
Athlete address (Suburb only):
Based on your allocation post tryouts, which teams will you be signing up for in 2020
Jinx (Yth 1)
GG's (Jnr 1)
Lady Luck (Snr 1)
Spark (Snr 2)
Black Magic (Snr 3)
Angels (Open 3)
Lady Clovers (Snr 4)
Perfection (International 6)
Matrix (Yth Hip Hop)
Revenge (Jnr Hip Hop)
Power (Snr Hip Hop)
Rage (Open Hip Hop)
White Magic ( JnrPom)
Glamour (Snr Pom)
Flash (Open Pom)
Desire (Open Lyrical)
Where you referred to us by any 2019 Pure Allstars athlete?
Athlete First Name
Athletes Last Name
Parent/Guardian #1 Name
Parent/Guardian #2 Name
Parent/Guardian #2 Email
Parent/Guardian #2 Mobile Number
If you wear lenses
Medication or Allergies
Other Medical History, Areas of concerns
Private Health Fund Name & Number
"FORMS TO RETURN"
The following can be referred to at the back of the club handbook. We do NOT require you to complete the forms manually and return them.
1) Recreational Competitive: Athletes to attend at least 1 competition 2) Semi-Competitive: One Competition Absence allowed (with prior approval) 3) Elite-Competitive: No Competition absences allowed
Any competitions you cannot do?
I, the undersigned parent, legal guardian, or I, myself do hereby grant permission for my daughter/myself to participate in any 2020 Pure Allstars practice/event. I have read and agree to the details outlined in the handbook. I further acknowledge and understand and agree that by participating at Pure Allstars there is a possibility of physical illness or injury (minimal, serious, and catastrophic) and that my daughter/myself will be assuming the risk of such injury by participating. I authorize any representative of the Pure Allstars party to consent and authorize any medical attention, treatment or administration of drugs by qualified and licensed medical personnel for my daughter/myself, which may become necessary.I understand I will be notified as soon as possible in the event of an emergency. I understand and agree that all expenses of such treatment are my responsibility. I agree to protect, defend and indemnify Pure Allstars, including its staff, employees and sponsors from and against any and all claims, demand, losses, suits, liabilities, costs, or other damages including court costs and attorney’s fees, arising from any injury to, or death of daughter/myself, the undersigned, or any other persons or damage to or destruction of property arising out of or in connection with any damage to third parties occasioned by, incident to, arising out of, or in connection with my daughter's participation. I understand that Pure Allstars produces promotional material about the program. I hereby grant Pure Allstars, the right to photograph and/or videotape my daughter/myself and utilize my daughter's/my face, likeness, voice and appearance as parts of the advertising and promotion of the program. By signing this document you are agreeing to adhere to the points above. Athletes are unable to participate in the program without the required signatures.
I have read, understood, and accepted the rules for membership.
Card listed will be used for the 2 month deposit, this deposit will be your last 2 monthly payments (October & November) therefore your final payment for the year will be due by September 2020
Credit card (no AMEX)
Invoice (card details still required for initial bio-monthly payment)
Credit Card Details
PAYMENT terms and conditions: 1) I understand if paying Annually, the entire fee will be charged upon this form being received. 2) I understand if paying by credit card, my credit card (details as above) will be charged at the beginning of each term beginning February 2020, ending September 2020. October & November payments are made upon sign up. October & November payments will be deducted as the form is received. 3) The credit card listed above will only be used for the payment of all monthly tuition, uniform & competition entry fees unless instructed otherwise by the cardholder. 4) If paying another way, invoices will be sent out in Feb, Apr, Jun and Aug. Invoiced fees must be paid within 2 weeks. A $50 late fee is added for overdue payments. Invoices will be sent to the email address provided on this form. 5) I understand the fees are prorated (refer to “Fees” in handbook) and there is a late start up fee of 1 month payment and an early exit fee of 2 months payment (your October & November payments which are made up front). All fees are non-transferrable & non-refundable.
I have read, understood, and accepted the terms for payments.
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