QSA Sport Aerobics

p: 0403694773
admin@qsasportaerobics.com.au
St John Vianney's
Brisbane, QLD, 4164, AU

St John Vianney's Catholic Primary School Sport Aerobics Sign-Up & Waiver!!
Instructions

Please complete the below to accept your child's position. *Please select a membership for the attending child/children only. Parents do not require a membership and do not need to check the 'I'll be attending' box.

Parent / Guardian

DOB is required for the signee of this form.


Dependant / Child #1

Emergency Contact Details
QSA Sport Aerobics Terms & Conditions

I understand that in signing this agreement I am liable to pay QSA Sport Aerobics term fees and competition entry fees by providing my account details below to be debited by EZIDEBIT, or via a pre-approved payment method. I agree to all terms and conditions listed below and in the 2025 QSA Sport Aerobics Primary School Agreement & Information Package. Nonrefundable dishonor fees up to $12 will be charged by Ezidebit & Clubworx for each missed payment, including payments missed due to insufficient funds. Failed payments will automatically reattempt 3 days after the initial failed debit. I understand QSA Sport Aerobics reserves the right to initiate Debt collection services should I fail to do so. 

TERM FEE DEBIT / DUE DATES:

Term 1 - 27th January, 2025 / $150 plus Ezidebit fee

Term 2 - 14th April, 2025 / $150 plus Ezidebit fee

Term 3 - 7th July, 2025 / $150 plus Ezidebit fee

Term 4- 29th September, 2025 / $150 plus Ezidebit fee

Once off $205 Competition Entry Debit - 10th March, 2025 (plus Ezidebit fee, or alternate pre-approved payment arrangement) *Does not apply to recreational students. 


IMPORTANT NOTES:

  • Competition dates are emailed at the start of the school year. The $205 once-off competition entry fee will be debited from your nominated EZIDEBIT account on the 10th of March, 2025, or is due by the 10th of March, 2025 as per your payment arrangement (For competitive students only)
  • Please note all debit dates in your calendar for reference, nonrefundable dishonor fees of up to $12 will be charged for each missed payment, including payments missed due to insufficient funds. Failed payments will automatically be rescheduled to 3 days after the initial failed debit. Contact QSA if you need to discuss your payments at admin@qsasportaerobics.com.au
  • Competitive athletes only: In the case of illness or injury only, we require 2 weeks' written notice and a medical certificate must be produced to cancel your child's membership.
  • Recreational students may cancel at any time with 2 weeks' notice before a scheduled debit and without a medical certificate. Refunds will not be provided under any circumstance.
  • Weekly classes are held in the School Hall during school term only. The first class of 2025 commences in the 2nd week of term 1. Classes are NOT held on public holidays, student-free days, or school holidays. 
  • For mid-term sign-on, fees will be adjusted to align with the weeks remaining that term before your waiver is approved and debits processed. 
  • The QSA Annual Membership of $55 is due to accept your child's position before they attend their first class (NEW members only). All athletes must hold a current membership. New members, please complete this 2025 Membership link: https://app.clubworx.com/s/l6DNQFg4  Existing members will have their membership fee automatically debited from their nominated Ezidebit account as per their previous year's agreement. * 2 weeks' notice prior to this debit date must be provided if your child is not returning the following year to avoid paying the scheduled membership fee at the end of the year. The Membership fee is NON-REFUNDABLE.
  • If you need to update your account details securely online at any time, please complete this link: https://app.clubworx.com/s/SP9r531s
  • Please forward all questions and queries to admin@qsasportaerobics.com.au

QSA Sport Aerobics Waiver & Release

I certify that my child enrolled to participate in the QSA Sport Aerobics Dance program is in excellent health and may participate in strenuous physical activities. I am aware Sport Aerobics and Fitness are vigorous activities that pose a risk of injury. QSA Sport Aerobics accepts NO Responsibility for injuries incurred before, during or after dance classes. I will not hold QSA Sport Aerobics liable for any claims, including Coaches, Sub Contractors and Volunteers. I have disclosed any medical conditions or pre-existing injuries that may be of concern. I agree to freely and voluntarily assume the full risk of any, and all injuries, liabilities, damages, costs or losses regardless of severity that may be sustained from participation in dance classes. I give permission for my child to receive emergency medical treatment. 


I agree to allow the coaches of QSA Sport Aerobics, to take video footage or still photography of my child participating in Sport Aerobics, dance and/or fitness activities, to be used for the purpose of coaching participants for the advancement of technical skills and social media use including QSA Sport Aerobics Facebook and Instagram accounts. I further agree that QSA Sport Aerobics may employ a professional photographer for events, including all Fisaf Events where they supply a photographer/video footage of competitions to be used and published in Fisaf advertising and social media accounts. 

Membership Options
Payments will be charged for each attending signee of this waiver.
Membership Summary
Parent / Guardian
No membership: not attending

Dependant / Child #1
Membership: St John Vianney's School Team 2025
Starts: Jan 27, 2025
Expires: after 46 weeks
Initial payment: $150.00, due 27 January 2025
Recurring payments: $150.00 every 12 weeks, starting 14 April 2025 until membership expires

Ezidebit Fees / Charges
One Time Setup Fee
$2.20
Bank Account
$1.29
MasterCard
2.29%
Visa
2.29%
Failed Payment Fee
$9.90
Payment Authority
Please note: this payment method will be used to collect payment for any memberships agreed to on this form.
Electronic Consent