Over 17's Registration Form
Under 17's must download the Junior Membership Form and have a Parent or Guardian complete and sign the consent form
Name
Email
Phone Number
Gender
Select an option
Male
Female
Date of Birth
Level Of Fitness
Select an option
Inactive
ModeratelyActive
Activ
Describe your Boxing level / experience
Select an option
Beginner
Some Experience
Advance
Have you sparred before?
Select an option
No
Yes
Do you consent to sparring using protective equipment as per England Boxing guidelines
Select an option
No
Yes
Have you trained previously with ABA Club
Select an option
No
Yes
Which Club?
Are or have you previously been a carded England Boxing Member
Select an option
No
Yes
Do you have you card /membership details?
Likely Membership Type and Payment Options
Select an option
Pay As You Go
Monthly Cash
Monthly Direct Debit
Emergency Contact Information
Emergency Contacts Phone Number
Relationship
Please tell us of any medical conditions or needs?
Choice 1
Had any serious illnesses or operations or been admitted to Hospital or Clinic
Ever had Convulsions or Fits
Ever had any head injuries or been unconscious or fractured your skull
Mental or physical problems at present, such as Hay Fever, Asthma or any Ear, Nose or Throat pro
On any Tablets or Medicines at present
Wear glasses or contact lenses
Any Deaf or hearing problems
Registered disabled
Any allergies
Any other medical conditions or needs we should know about?
As per General Data Protection Regulations (GDPR) In order for us to hold information about yourself and your child we now need your consent. Can you please take the time to read the statement below. "At Halifax Star Boxing Club we take our privacy
*Pictures/video of classes may be posted on social media, website etc for marketing purposes. By completing this form, you are giving your consent for such to be used as stated.
*I have completed this form as honestly and accurately as possible, I understand that Halifax Star Boxing BC can only provide the best practice based upon the information provided
SUBMIT Now
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