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Date of Birth
Gender
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Other
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Name of the child
Title
First Name
Last Name
Address
Address 1
Address 2
Town / City
County
Postcode
Contact Information
Parent / carer's details
First Name
Last Name
Email Address
Home Number
Mobile Phone
Medical / Emergency Information
Medical Information
Please provide details of any medical conditions, or any medication taken on a regular basis.
e.g. Hayfever, Asthma, Diabetes, etc. Leave blank if none.
Emergency Contact
Name and telephone number of a person to contact in case of an emergency
if different to parent / carer.
Do you consent to a member of staff at Go:ver Gym providing medical treatment if required?
Photography
Do you consent to Go:ver Gym taking photographs / videos, to be used in publications or other media including (but not limited to): the club website, brochures, newspapers, magazines, etc. Note: To ensure the privacy of individuals (including any children), images will not be identified using full names or personal identifying information without written approval from the photographed subject, parent or legal guardian.
Safeguarding
Do you consent to a member of staff at Go:ver Gym contacting your child directly via text or Email?
Child's Email Address
Child's Mobile Phone
Communication Preferences
From time to time we like to send relevant information, news and promotions that we think you might find interesting. Please choose how you would like to receive this. You can opt-out later at any time.
Email
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Push Notification
Traditional Mail
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Additional
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terms and conditions
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