ChildName* First Last Nickname Gender* Male Female AgeDate of Birth*Year20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Month123456789101112Day12345678910111213141516171819202122232425262728293031Medical Conditions,Allergies, Behaviours ectT-shirt size 3–4 years 5–6 years 7–8 years 9–10 years School Name of Teacher Parent / GaurdianRelationship to Child Parent Gaurdian Sibling Name First Last Mobile Office Email Fees and T&C'sOnce-off annual registration* Option 1 (R150): Includes registration, t-shirt, annual medal, term certificates Option 2 (R450): Includes registration, Dizzy Dice, t-shirt, annual medal, term certificates Class fees* At your child’s school: R620 per term At our Studio: R850 per term Payment method* Pay per term Pay per year (10% discount) Terms and Conditions I understand that term fees are payable by the 2nd week of each term. One month’s written notice is required should I wish to terminate participation during the course of the year. I release and indemnify the Contractors, Venues, Gymjam against any claim arising out of this contract in relation to an injury/death/ liability/ loss resulting from participation in the activity. I confirm that I have read and understand this contract prior to signing it and agree this will be binding upon my heirs next of kin, Executors and administrators. I hereby give consent for the child enrolled under this contract to participate in the activities presented by Gymjam and agree to abide by the terms and conditions set out above. Terms and Conditions* I have read, understand and agree with all terms and conditionsConsent I give permission for my child to be photographed while participating in any gym jam activities and give consent for the photographs to be used for marketing purposesSignature*