2024 Nepean Club Member Information Form

www.nepean.physie.com.au

Please fill out this form to secure your placement in our 2024 classes and to receive the BJP registration link.

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* 1. Student One Information:

Students Name:

D.O.B:

Address:

Suburb:

Postcode:

Email Address:

Phone Number:

Please note any medical/allergy information:

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* 2. Student Two Information:

Students Name:

D.O.B:

Address:

Suburb:

Postcode:

Email Address:

Phone Number:

Please note any medical/allergy information:

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* 3. Student Three Information:

Students Name:

D.O.B:

Address:

Suburb:

Postcode:

Email Address:

Phone Number:

Please note any medical/allergy information:

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* 4. Emergency Contact Information:

Parent/Caregiver Name:

Email Address:

Contact Number:

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* 5. Class/Classes we intend on attending (you may choose more than one)

Monday - Windsor

Tuesday - Werrington

Thursday - Londonderry

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* 6. If you are new to Physie, where did you hear about us?

	Please tick a box
Website	Website Please tick a box
Facebook	Facebook Please tick a box
Shopping Centre Promotion	Shopping Centre Promotion Please tick a box
Flyer in letterbox	Flyer in letterbox Please tick a box
School newsletter or flyer in school bag	School newsletter or flyer in school bag Please tick a box
Newspaper	Newspaper Please tick a box
Friend	Friend Please tick a box
Word of Mouth	Word of Mouth Please tick a box
Community Event	Community Event Please tick a box

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* 7. I give consent for images of me/my child to be used in publicity materials for Nepean Physie Club and/or BjP Physical Culture.

YES

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* 8. I agree for me or my child to attend physie classes and to undertake all activities and/or to participate in physie classes. I understand that although Nepean Physie attempt to minimise any risk of personal injury within practical boundaries, accidents do happen and all physical activities carry the risk of personal injury. I acknowledge that there is an inherent risk of personal injury in physical activities that will be undertaken in the class/as part of the program and I accept that risk.

YES

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* 9. I agree to abide by Nepean and BJP's Code of Conduct for members as set out below.

- Treat all members as you would like to be treated.
- Show respect for and co-operate with your teachers and other officials, without them there would be no competition.
- Be humble when you win and graceful when you lose.
- Don’t seek excuses or blame the judges or your teacher when you lose but aim for self-improvement.
- Do not criticise other members or competitors.
- Be a good sport. applaud other competitors whether they are from your club or another.
- Work equally hard for yourself and your team. The team will benefit and so will you.
- Respect the teachers decision and expertise in regards to the selection of teams and group performances.
- Be loyal to your club and support it.
- Enjoy yourself and have fun.
- Parents and members must demonstrate appropriate behaviour in class, club functions, performances and at all competitions.
- Parents and members must comply with any directives issued by Nepean associates or by BJP officials.
- Abide by the BjP rules and Code of Conduct.
- Maintain term fee's and payments required for registration and attending lessons.
- No filming in class under any circumstances unless given direct permission by the teacher.
- Be mindful to avoid comments that are offensive to Nepean, BJP and its members, including what you post on social media.

YES