Follow Us
Home
About
About SRGC
What is Rhythmic Gymnastic
Safe Sport
Management
Mentorship
Movement
Sport Tech
Sustainability
Program
Academy
Empowerment
Calendar
Profile
The Team
Profile
News
Gallery
Connect
ACADEMY
FOR ADMISSION
SECTION A: GYMNAST DATA
(as in IC)
Kindly complete all sections of the forms forms
PLEASE USE BLOCK LETTERS THROUGHOUT
Applying to start in:
Term 1 (Jan-Mar 2019)
Term 2 (Apr-June 2019)
Term 3 (July-Sept 2019)
Term 4 (Oct-Dec 2019)
First Name
Last Name
Date of Birth
Birth Certificate/NRIC
Home Address
Nationality
Home Tel No
School Address
Mobile No
Email Address
School Tel No
SECTION B: SIBLINGS
Siblings applying into - or currently in - Sarina Rhythmic Gymnastics Club
First Name
Level
Recreational
Competitive
First Name
Level
Recreational
Competitive
SECTION C: PARENTS DATA
Attention correspondence to:
Father
Mother
Guardian
Father
Title
(eg. Mr, Dr. Tan Sri, Dato)
Priority to contact for club matters
1st
2nd
First Name
Last Name
Home Address
(if different from child's home address)
Home Tel No
Mobile No.
Email Address
Mother
Title
(eg. Mr, Dr. Tan Sri, Dato)
Priority to contact for club matters
1st
2nd
First Name
Last Name
Home Address
(if different from child's home address)
Home Tel No
Mobile No.
Email Address
PARENTS' MARITAL STATUS
Married
Separated
Divorced
Widowed
Other
STEPPARENT
GUARDIAN
Title
(eg. Mr, Dr. Tan Sri, Dato)
Priority to contact for club matters
1st
2nd
First Name
Last Name
Home Address
(if different from child's home address)
Home Tel No
Mobile No.
Email Address
Emergency Contact
(if persons listed above are not reachable in case of an emergency)
First Name
Last Name
Relationship to Member
Mobile No
SECTION D: RHYTHMIC GYMNASTICS HISTORY
Current Club
(if applicable and relevant)
Club Name
Principal's Name
Club Address
Club Tel No
Admission Date
Withdrawal Date
Joined in Grade / Level
Currently in Grade / Level
Reasons for leaving this club
Previous Club
(if applicable and relevant)
Club Name
Principal's Name
Club Address
Club Tel No
Admission Date
Withdrawal Date
Joined in Grade / Level
Currently in Grade / Level
Reasons for leaving this club
1) Has the gymnast been placed out of the age group/level for her age?
Yes
No
If YES, please give details
2) Has the gymnast been involved in serious disciplinary action?
Yes
No
If YES, please give details
3) Does the gymnast have any learning difficulties, physical disabilities or psychological needs?
Yes
No
If YES, please give details
4) Has the gymnast received any learning support?
Yes
No
If YES, please give details
5) Has the gymnast participated in any club, district, state or national level competitions?
Yes
No
If YES, please give details
6) Friendship patterns
Is initially shy with people
Makes friends easily and quickly
Has difficulty making friends
Prefers a small group of friends
Seems to prefer younger children
Seems to prefer older children
7) HAny other information you would like SRGC or the coach to take note about the gymnast?
Yes
No
If YES, please give details
SECTION E: HEALTH INFORMATION
1) Does the gymnast have asthma, diabetes, epilepsy, significant allergies or other medical conditions?
Yes
No
If YES, please give details
2) Has the gymnast suffered any bone fractures or undergone surgery in the past?
Yes
No
If YES, please give details
3) Is the gymnast taking any regular medication?
Yes
No
If YES, please give details
Subscribe To Our Newsletter
Subscribe Now!
Leave this field empty if you're human:
SRGC Locations
SRGC Damansara
Paum Club House, Kuala Lumpur
SRGC Let’s Gym Locations
elc International School
Sungai Buloh, Selangor
Garden International School
Mont Kiara, Kuala Lumpur
GEMS International School
Subang Jaya, Selangor
HELP International School
Shah Alam, Selangor
Taylor’s International School
Puchong, Selangor
Tadika Diyana
Tmn Tun Dr Ismail, Kuala Lumpur
Contact
info@srgc.asia
+(60)12 566 2446
sarinarhythmicgymnasticsclub
srgc.asia
srgc.asia
srgc.asia
srgc.asia
Top
