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KnockOut LGBTQ+ registration
FOR CLUB USE ONLY.
Participant registration form is required to be filled out ONCE to attend class.
We do not share your information externally without your permission.
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* Indicates required question
What is your email address?
*
Your answer
First name
*
Your answer
Surname
*
Your answer
Mobile phone number
*
Your answer
Mailing address including Post code
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Emergency Contact Name?
*
Your answer
Emergency Contact Mobile Number
*
Your answer
Do you have any medical condition(s) that may affect your participation in boxing training, or that will require accommodation? *
*
Yes
No
If you answered "YES" to the last question, please list relevant medical conditions below and make sure to inform the Coach before commencing class
Your answer
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