Ambassador Application Form
Entries close 20th June 2021
Name of participant
*
Email
*
example@example.com
City/State - Australian Residents Only
*
Age
*
Have you ever purchased from us?
*
Yes
No
Do you own any of the following brands?
*
US Glove
Tiger Paws
Drybands
Plum Activewear
Destira
None of the above
What brands are you most interested in?
*
US Glove
Tiger Paws
Drybands
Plum Activewear
What social media accounts do you have?
*
Instagram
Facebook
Tik Tok
Youtube
Who runs your account?
*
Parent
Child
Both
List your social media account names
*
Do you have permission from a parent or legal guardian to be a GYM GRIPS Co Ambassador?
*
Yes
No
N/A I'm over 16 years old
Consenting parent or legal guardians details (if under 16)
Name
Email
Any comments you would like to include
Submit
Should be Empty: