Kingfisher Club Covid-19 Self/Family Declaration Form

Kingfisher Club Gymnastics Academy Booking Form
Parent/Guardian Name *

First Name Last Name
Parent/Guardian Email Address *
example@example.com
Parent/Guardian Contact Number *
Landline or Mobile Number
Child 1 *

Name D.O.B. Previous Gymnastics Experience?
Child 2

Name D.O.B. Previous Gymnastics Experience?
Child 3

Name D.O.B. Previous Gymnastics Experience?
Child 4

Name D.O.B. Previous Gymnastics Experience?
Are there any health issues that the gymnastics supervisor should be aware of? *
Preferred Day for Gymnastics Academy
Parent/Guardian Declaration:

1. I confirm that the above answers are correct, at this point in time, to the best of my knowledge and belief.
2. I will ensure that I inform the club and coach at once if any of the above information changes.
3. I am aware that there are Desginated Liaison Person(s) in place.
5. I have been made aware that only children aged over 4 years can enrol in Kingfisher Gymnastics Academy
6. I agree that my child will abide by the rules of Kingfisher Club and follow the instructions of staff at all times.
7. I have been made aware that photography is not permitted in areas of the sports centre.
8. By signing this form I confirm that I have read and accept the declaration above.
Date *

Day Month Year
Date
Hour Minutes AM/PM Option
Signature *

Clear
Should be Empty:

Kingfisher Club Gymnastics Academy Booking Form