Palm Beach After-School Enrolment Form

Childs Name *
Childs Name
Pick up from classrooms can be arranged for younger children - list class below and contact us directly via phone/email if you are interested.
Parent/Guardian Name *
Parent/Guardian Name
Address *
Emergency Contact Name *
Emergency Contact Name
Class Fees ($5 per class based on 10 week blocks) *
New registrations welcomed anytime - fees adjusted pro rata. Registration and payment details must be completed prior to first class.
Children’s Physical Activity Readiness Questionnaire (PAR-Q) Screening Form *
The purpose of this form is to provide us with specific details of your child’s medical history and general health information so that we can avoid any risk of injury or illness. Completion and submission of this questionnaire is mandatory before your child is permitted to participate in any Fitletica program. Has your child ever experienced any of the following. Please tick if applicable:
Photo Permission *
We will occasionally take pictures during some of our classes which may appear on our website, newsletters or on our social media pages. We will never provide names or any other specific information on your child. Do you give permission for occasional photos to be taken of your child?
Terms and Conditions/Consent *
Please click link on bottom of page for full Terms and Conditions.