Sukhari Muay Thai Kids Class-SUKHARI MUAY THAI

Sukhari Muay Thai Kids Class

Child Participation Form

Thank you for your interest in our Muay Thai Classes for Kids!

To get started we would like to gather some basic information from you and your child/ren before they participate in a Muay Thai Group Class at Sukhari Muay Thai Gym.

Please take 2 mins to complete all relevant questions. All information you provide is kept safe and confidential.

If any details you provide change after you have submitted the form, contact us and we can update for you accordingly.

Please note: We are not taking membership sign ups or payments on this form.

If there are any queries regarding the form, please do not hesitate to get in touch with us.

Sukhari Muay Thai Pty Ltd

(Find us inside Athletique Gym)

2 Albert Street, Preston, Vic 3072

Phone: 0406 035 767

Email: info@sukharimuaythai.com.au

Web: www.sukharimuaythai.com

ABN: 86 651 445 082

I am interested in

How many children do you have trialing/enrolling into the Muay Thai Kids Group Class?

Parent/legal Guardian's Details

Parent/Guardian First Name

Parent/Guardian Last Name

Phone Number

Emergency Contact Person

In case of an emergency list your first point of contact

Is the Emergency Contact Person same as above?

If yes, skip and go to next question.

If no, complete Emergency contact details below.

Other

Emergency Contact Person

Emergency Contact Number

CHILD 1

Complete Details for Child 1

Child's First & Last Name

Child's Date of Birth

Child's Gender

Please advise of any current medical conditions/injuries we should be made aware of

CHILD 2

Complete Details for Child 2

Child's First & Last Name

Child's Date of Birth

Gender

Please advise of any current medical conditions/injuries we should be made aware of

CHILD 3

Compete Details for Child 3

Child's First & Last Name

Child's Date of Birth

Child's Gender

Please advise of any current medical conditions/injuries we should be made aware of

Kids Classes

Monday to Thursday 4:30pm - 5:15pm Saturday 9:15am - 10:00am No classes Friday

Which Class/es are you interested in attending? This is to give us an indication only

Do you have any comments/questions for us?

Release Form & Waiver of Liability

Please read the following text carefully before signing: By booking into a Sukhari Muay Thai class, the participant (or if the participant is a minor, the participant's Parent or legal Guardian) agrees to the following: 1. I voluntarily participate in Muay Thai training and fully understand the potential risks associated with the sport, including but not limited to punching, kicking, elbowing, clinching, kneeing, falls, and pulls. 2. I understand that these activities may result in participant experiencing bruising, scratches, and soreness. 3. I assume full responsibility for any and all actions that I take while participating in Muay Thai. 4. I absolve Sukhari Muay Thai, its agents, workers, and associates of any and all liability, claims, demands, actions, and any loss, damage, or injury that may occur as a result of my participation in this sport. By signing below, the participant (or if the participant is a minor, the participant's Parent or legal Guardian) agrees to all of the above terms and conditions.

I agree to the terms & conditions

Parent/legal Guardian (Enter your full name)

Your Signature

Date Signed

Thank you for taking your time to fill out your details.

Please proceed to submit.

Warm Regards

Sukhari Muay Thai