CrossFit Kids and Teens - Term 2 - 2025 Returning Child Sign-Up

Name of Child

First Name

Last Name

Name of Second Child

If applicable

First Name

Last Name

Date of Birth (Second Child)

If applicable

MM

DD

YYYY

Name of Parent/Caregiver Completing Form

First Name

Last Name

Contact Phone Number of Parent/Caregiver

If changed recently

Email of Parent/Caregiver

If changed recently

Emergency Contact Name, Phone and Relationship

If changed recently

Please list all current medical conditions and injuries

If you are registering multiple children please clearly list which conditions relate to which child

Which program are you enrolling in?

Kids (5-8) - Tuesday 3:45pm

Kids (9-12) - Wednesday 3:45pm

Teens (13-17) - Thursday 4:15pm

If you are registering multiple children please list which program each should be enrolled in

Additional Information

If you think there is any additional information for us to know about your child to best support them please let us know here

Checkbox

By ticking this box you agree and understand this form is for filing and set up purposes only. The membership Terms and Conditions are to be signed online using our member app before the first class by the parent/caregiver on behalf of their dependant.

Agree