Name *

First Name

Last Name

Phone *

(###)

###

####

Medical Consent *

In the event that the above named member is injured whilst in the care of the club.

I give consent for medical care to be administered

I do not give consent for medical care to be administered

Medical Conditions *

Does your gymnast have any medical conditions that we should know about. E.g asthma, allergies and any other medical conditions that would prevent your gymnast taking part

Yes

No

If yes, please let us know below.

Photographic Consent *

From time to time, we would like to take photographs and videos that may be used on our website and on our social media pages.

I consent

I do not consent