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Under 18s Joining form

U18 joining form

Personal details

Child details and parent / carer contact details

About your child

First Name

Last Name

Address

Address Line 1

Address Line 2

Post Code

Date of Birth

Gender

Male

Female

Parent / Carer information

First Name

Last Name

Relationship to the member

Parent/ Carer Mobile number

Parent/ Carer Email

Home phone

Emergency contact

...in the event of an incident or accident we need an emergency contact.

Are the details above the person we should contact in an emergency?

Yes

No, please contact someone else

Emergency Contact Name

Last Name

Relationship to member

Emergency Mobile number

Boxing information

Your child's experience

Have you boxed before?

Yes

No

Where have you boxed before

West Ham Boxing Club

School

Other Boxing Club

Local Authority coaching session

Other

Other- please specify

Medical Information

Please give us any important medical information we should be aware of (severe allergies, epilepsy, asthma etc)

Medical details

© West Ham Boxing Club

Jordan Hall, 2 London Rd, London E13 0DN