Kids Trial Form

Kids Trial Form

How exciting!!! It’s time to book your child’s trial session! Please fill out the details below so we can book your place and prepare for your child’s first class! Let’s get ready to RUMBLE!!
Childs Name*

First NameLast Name
Date Of Birth*

DayMonthYear
Age*
Years
Months
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian 1 Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (00) 0000-0000.
Email*
example@example.com
Parent / Guardian 2 Name (if applicable)

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (00) 0000-0000.
Email
example@example.com
Internet search on googleWord of mouthDrove pastInstagramFacebook
YESNO
What Martial Art did your child participate in*
Which Gym/Club did your child previously train at*
Less than 6 mths6-12mths12-18mths1.5-2yrs2-3yrs3-5yrs5-10yrs
Junior BJJ 10-12yrs Monday & Wednesday 4:30pmTeen BJJ Monday & Wednesday 5:30pmJunior Mod Thai 10+ Monday & Wednesday 5:30pm - Boxing gloves required for trialJunior TKD 7-12yrs Tuesday & Thursday 5:30pmJunior BJJ 5-7yrs Tuesday & Thursday 4:30pmJunior BJJ 8-10 Tuesday & Thursday 5:30pm
Which date would you like to attend for your initial trial class? Please select below: * Please note once you have submitted this form we will contact you to confirm that we have a trial place available on your prefered date or to make other arrangements if we do not have a place available
Date*

MonthDayYear
Date
Now it's time to complete your child's Health Screen...

PRE EXERCISE SCREENING TOOL

This screening tool does not provide advice on a particular matter, nor does it substitute for advice from an appropriately qualified medical professional. No warranty of safety should result from its use.

The screening system in no way guarantees against injury or death. No responsibility or liability whatsoever can be accepted by Metamorphica Martial Arts Pty Ltd for any loss, damage or injury that may arise from any person acting on any statement or information contained in this tool.

Pre Exercise Screening Questions

1. Has your medical practitioner ever told you that you have a heart condition or have you ever suffered a stroke?

2. Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise?

3. Do you ever feel faint, dizzy or lose balance during physical activity/exercise?

4. Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?

5. If you have diabetes (type l or type ll) have you had trouble controlling your blood sugar (glucose) in the last 3 months?

6. Do you have any diagnosed muscle, bone or joint problems that you have been told could be made worse by participating in physical activity/exercise?

7. Do you have any other conditions that may require special consideration for you to exercise?

Screening Outcomes

IF YOU ANSWERED YES:

to ANY of the 7 questions, please seek guidance from an appropriate allied health professional or medical practitioner prior to undertaking exercise.

ALL NO ANSWERS:

IF YOU ANSWERED 'NO' to all of the 7 questions, and you have no other concerns about your health, you may proceed to undertake light-moderate intensity physical activity/exercise. You meet the criteria to proceed
I answered 'NO' to all 7 questionsI answered 'YES' to at least one question and acknowledge I need to supply written medical clearance before starting training
Child Health Screen
In order to provide the best teaching and learning experience for your child please let us know if the following applies to your child.
Does your child have any of the following?

Select all that apply
ADHDASDDyslexiaAsthma*Type 1/ Type 2 DiabetesNone
Learning IssuesSensitivitiesBehavioural IssuesAllergies/Anaphylaxis*None
Please List*
*If your child has asthma or anaphlaxis their medication must be brought to every class to be permitted to train.
Is there anything else you would like us to know about your child
ALMOST THERE!!

Here a few things to know and prepare for your first class:
- Please bring your child to their trial in a fresh and clean plain black or white T-Shirt (singlets are not appropriate) and either long sport shorts, leggings or tracksuit pants (skirts and dresses are not appropriate).
- All hair is to be tied back with hair ties and no bobby pins or hair clips are to be used.
- No jewellery is to be worn in any classes, if unable to be removed it must be taped up.
- Shoes and socks are to be removed before your child steps on the mat. We actually recommend wearing thongs for easy on and off.
- All fingers and toe nails are to be cut short and filed to ensure safety to all other members.
- Please ensure sanitiser is applied to both hands and feet before your child steps on the mat - sanitiser can be found on the poles in front of the mat.
- If your child needs to use the bathroom during the class: shoes must be worn in the bathrooms and sanitiser must be reapplied to both hands and feet before returning to the mat.
- Trials for Junior Mod Thai must provide their own training gloves. (We are unable to provide rental gear for hygiene reasons) Gloves can be purchased at reception or sports stores locally beforehand.
Now just complete the consents below and we are good to gooooo!! 💪🏻
I agree to the use of an electronic signature to confirm I agree to terms and conditions of training at Metamorphica Martial Arts Pty Ltd. Signature:*
Should be Empty:

Kids Trial Form

Child Health Screen

Does your child have any of the following?