SMSLSC Gym Membership & Induction Form

Gym Membership & Induction Form
Season*
Name

First NameLast Name
Email
example@example.com
DOB

DayMonthYear
Date
Emergency Contact Name
Emergency Contact Phone
YesNo
YesNo
YesNo
If you answered 'yes' to any of the medical questions please upload medical clearance or information to support your use of the gym.

Cancelof
YesNo
Print Name

First NameLast Name
YesNo
Signature
Please ensure you read the current club document at the following link

SMSLSC Gym Instructions and Guidelines
Should be Empty: