Gym, Exercise and Sport Enrolment Form

Member's Name *
Member's Name
Member's Date of Birth *
Member's Date of Birth
Parent/Guardians Name *
Parent/Guardians Name
Home Address *
Home Address
Timeslot (select one or multiple) *
What is your preferred day/time slot?
Help us get to know your child
eg. allergies, conditions...
E.g. use of visuals, sign language e.t.c
E.g. specific strategies for our staff to be aware of
Would you be interested in speaking with our Occupational Therapist about our services? *
Were you on the look out for a program like this? When did you first hear/see our name?
Media consent *
As the parent/guardian of the child listed above, I give/do not give The Tippy Toe Co. Incorporated permission to use professional images and video for promotional purposes. This may include; media articles and editorials, TTTC website, print material (flyers, posters, etc), social media posts and grant applications.
Subscribe *
To the TTTC emailing list to receive updates, the quarterly newsletter and other news and events.