Physio Equipment Class Enrolment Form Term 2 2019 (10 Weeks)

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Client 1

Load contact details using username and password
If you do not have a username and password, one will be created for you when you submit this form.

Client Details

Male Female

Parent/Guardian Details

Address

Health and Fitness

Dates

From 29-Apr-2019 to 05-Jul-2019

Days & Times

Once a time slot is full you will be asked to make another choice.

Time Mon Tue Thu Fri
9:00 am
Physio Equipment Class (Carolyn)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
FULL
Physio Equipment Class (Carolyn)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
FULL
9:30 am
Physio Equipment Class (Therese)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
FULL
Physio Equipment Class (Therese)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
FULL
10:15 am
Physio Equipment Class (Carolyn)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
FULL
Physio Equipment Class (Carolyn)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
FULL
1:30 pm
Physio Equipment Class (Therese)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
FULL
Physio Equipment Class (Therese)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
4:15 pm
Physio Equipment Class (Therese)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
FULL
Physio Equipment Class (Carolyn)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
5:30 pm
Physio Equipment Class (Therese)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
Physio Equipment Class (Therese)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
FULL
Physio Equipment Class (Carolyn)
Physiotherapy Posture & Pilates 48 Eaton Drive Eaton
FULL

DISCLAIMER:
I hereby agree to assume all risks and responsibilities surrounding my (or my child's) participation in the program under the instruction of Physiotherapy Posture & Pilates coaches. I understand that similar to all sporting activities, there is a risk of damage to personal property, injury or death which may result from causes beyond the control of, and without fault or negligence of Physiotherapy Posture & Pilates, its officers, agents, or employees, during the period of my (or my child's) participation. I understand completely the above agreement and agree to be bound thereby. By registering on our site you agree that we may send you email related to our facilities and programs. We will not provide your details to any other company.


Agreement

26-Jun-2019

Payment Method

There are no refunds for any enrolments into Physiotherapy Posture & Pilates related programs. When you sign/tick confirmation for this enrolment you are acknowledging that you know this as a fact and have accepted it as a condition.
$300.00 10 week term fee 1 class per week paid by Week 1
$500.00 10 week term fee 2 classes per week paid by Week 1
$250.00 10 week term fee for one when 2 or more Family members enrol in class paid by Week 1
$32.00 Casual rate per session (Confirm dates with reception) (per session)
$270.00 MONDAY ONLY ENROLEES 9 week Term fee due to WA Day 3rd June
$0.00 Other option. Discuss with reception staff for pricing options
$0.00
Bank Transfer
Bank details will be provided on the next screen
Cash
Term Fee enrollees payment must be made by Week 1