SEAL PUPS REGISTRATION


  Personal Details
  Child's Name Surname
  Date of birth Sex
  Address
  Postcode
  Email Confirm Email
  Password Confirm password
  Contact Number
  Class/Year School
  Parent's Name Parent's Contact Number
  Is there anything you want to tell us about your child?
  How Did You Hear About Us?

  Enrollment Details
  State
  Course Location
  Course Commencement Date
  Course Fees  
    EACH NEW RECRUIT RECEIVES A FREE ORIGINAL BOOTCAMP T-SHIRT UPON ENROLMENT. Please select your size.
  T-Shirt Size
  Payment Method Cash By Cheque Bank Transfer

  Medical/Health Form Pre-Exercise Questionaire
  Any major illnesses or disabilities?
  Is your child presently exercising? Yes No
  Brief outline
  Has your child been hospitalised recently? Yes No
  Does your child suffer from any of the following?
 
Heart disease Yes No Asthma Yes No
Heart Condition Yes No Diabetes Yes No
Back pain Yes No Epilepsy Yes No
Spinal Injuries Yes No Hernia Yes No
Arthritis Yes No Heart Palpitations Yes No
Joint pains Yes No Hi/low Blood Pressure Yes No
Tightness in Chest Yes No Rheumatic Fever Yes No
Liver/Kidney Condition Yes No Regular Headaches Yes No
Infections Yes No Muscular pain/cramps Yes No
Chronic Cough Yes No High Cholesterol Yes No
Bladder Weakness? Yes No Allergies to Grass? Yes No
   
  Are there any conditions that may limit your physical activity? Yes No
  Comments
  Yes, details above reflect my current medical & health condition

 
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  I have read and agree to the Terms and Conditions and Attendance Agreement
 

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