Club Membership Registration Form

2024 Victorian State Cheerleaders Membership

Athlete Registration Form
Athlete Name*

First NameLast Name
Athlete DOB*

DayMonthYear
Date
Parent/Guardian Name (N/A if over 18)*

First NameLast Name
Guardian Email *
Primary Phone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What team are you registering for in 2024? Please tick all teams.*

RecreationalMini NoviceZorros Elite Youth 1Arctics Elite Senior 2Comets Elite Senior 3Vixens Elite Open 4Fennecs Development 2005 Development 5
Please note that all Elite teams will be traveling to AASCF Nationals December 5th - 8th on the GOLD COAST. All athletes registering for an Elite team must attend. Each athlete must book their own flights and accomodation. Athletes under the age of 18 require a parent or guardian to attend. Please see our information pack for more information on Nationals.*

I understand
Athlete Medical Details
Additional Emergency Contact*

First NameLast Name
Emergency Contact Number
Does the athlete have ambulance cover?*

YesNo
We recommend all athletes have ambulance cover.
Does the athlete have any allergies or learning disabilities that we need to know?*

YesNo
Please list any relevant information below:*
eg: allergic to bandaids
Does the athlete have any injuries heading into the 2024 season?*

YesNo
Please list any relevant information below and course of action:*
eg: fractured toe, off the foot for 2 weeks
Payment
Please choose your payment plan for the 2024 season. Invoices and direct debit set up will be emailed to the email address provided on this registration. Competition packs and uniforms will be invoiced in terms 1, 2 and 3.*

Direct debit fortnightly (incurs additional fees)Direct debit monthly (incurs additional fees)Pay per term upfront

My Products*

2024 Membership FeeIncludes: 2024 Club T-shirt, 2024 Athlete Insurance and 2024 Administration Costs, 2024 Team Registration.

$50.00AUD QuantitySize
Item subtotal:$0.00AUD

Total

$0.00AUD

Payment Methods

Credit Card

Apple Pay

Athlete Signature*

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Parent/Guardian Signature*

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Should be Empty:

2024 Victorian State Cheerleaders Membership

Athlete Medical Details

Payment

Payment Methods