ONLINE ENROLMENT FORM
Course Enrolling In Course Date
Please note, all course participants must have a card made for them at Flinders Sport & Fitness. At the time of making this card
any concession card / proof of ID will be requested prior to you being accepted into the course. Thank you.
Surname Given Name Date of Birth
Address Suburb Post Code
Phone Number Mobile Number Male / Female
Please note that there are limited positions available in each course, as such registrations are taken on a first come, first served basis
anyone who registers and pays for a program which fills will be offered a full refund, or the opportunity to take place in a future
course. This form must be accompanied with full payment. Thank-you.
Payment Method Credit Card Number
Expiry Date (mm/yy) Credit Card Name
CONDITIONS OF ENROLMENT:
I understand that FUSF and/or employees cannot be held liable for any personal injuries or accidents arising from participation in
any FUSF course or activity unless the organisation if found to be negligent. Participants ust be physically and mentally capable to
undertake the activity they involve themselves in. I acknowledge and understand that I make that judgement and that I undertake
the activities at my own risk.
I accept that changes to enrolment will only be accepted prior to the close of registration. All programs are not refundable, except
by the submission of a medical certificate to verify my inability to participate.
Courses may be cancelled where insufficient numbers are enrolled or where weather conditions are unsuitable. In the event of a
cancelled course all fees will be fully refunded to paid up participants.
A completed medical declaration, as found on the accompanying page must accompany this form to complete enrolment. This may
be printed and brought in, or filled in and completed at Flinders Sport & Fitness prior to beginning the course.
Signed Date Submit by Email