Postnatal Program Registration

This registration form must be completed before commencing the 6-week postnatal program.

Please note, for safety purposes, all participating mothers must be at least six weeks post-partum and have attended the 6-week check-up with a doctor to participate in the program.

Your Details

Name

Email

Mobile

Date of Birth

Next of Kin

Contact Number

Baby's Name

Baby's Date of Birth

Exercise History

What exercise did you do during pregnancy?

What exercise are you currently doing?

To assist the trainer providing suitable exercises for you, please provide details about any abdominal separation and/or pelvic floor issues

Are you currently doing Pelvic Floor Exercises?

Yes

No

Please provide details of any injuries/conditions that your trainer should be aware of

I wish to register for

Aqualink Nunawading - Monday 1.15 pm - beginning 16 September

Aqualink Box Hill - Thursday 1.15 pm beginning 31 October

Terms & Conditions

_{Registration

I understand that I must register for the Post Natal Program by completing the registration form. To confirm my place in the program I must pay the full fee of $96.00 before the commencement of the program when I submit the registration form.}

_{Privacy Statement

The City of Whitehorse is fully committed to complying with the provisions of privacy legislation. This means that Council respects the privacy of individuals and complies with the Privacy and Data Protection Act 2014 in the collection, use, storage, management, provision of access and disposal of personal information. The information collected from the form is for the purpose of enroling participants in the Post Natal Program, communicating with participants in regards to the Post Natal Program, assessing individual health and fitness levels during pregnancy and after the birth of the baby, ensuring participating mothers are at least six weeks post-partum, ensuring the centre has access to a nominated emergency contact for participants and communication with participants about a repeated Post Natal Program, should that event occur.}

_{The intended recipients of the information are authorised Council officers. Council may disclose the information to law enforcement agencies, courts and other organisations authorised to collect it. For more information, please refer to Council’s Privacy Policy.}

_{Consent Clause

I, the undersigned approve of the enrolment and agree to abide by the rules and conditions of Aqualink. I authorise you in the event of an unforeseen accident or illness to obtain such medical assistance as necessary and agree to meet any expenses hereto.}

_{Liability

To the extent permitted by law, Aqualink and the City of Whitehorse shall not be liable or responsible to you for any direct, indirect or consequential injury, loss or damage whatsoever and however arising. Aqualink and the City of Whitehorse are not responsible for lost or stolen items or damage to property or vehicles. Acknowledging this risk, you agree to use the Centre at your own risk.}

_{Cancellation

Should you be forced to abandon this program due to illness, a refund will be offered pro-rata on the balance of classes remaining, provided a medical certificate is obtained and sighted.}

_{Lawful Authority

I take full responsibility/supervision of my baby during these classes.}

I agree to the above T&Cs

Select the checkbox to confirm this is a valid submission.

Back to Post Natal

Aboriginal flag TSI flag Whitehorse City Council acknowledges the Wurundjeri Woi-wurrung people of the Kulin Nation as the Traditional Owners of the land. We pay our respects to their Elders past, present and emerging.

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Postnatal Program Registration