Boxing Registration Form

Rise and Shine Boxing

Participant's Information

Participant's Name

First NameLast Name

Are you over 18 ?

Participant's /Legal Guardian Name

First NameLast Name

Address

Street Address

Street Address Line 2

City

Postal / Zip Code

Home Phone

Area CodePhone Number

Cell Phone

Area CodePhone Number

E-mail

Boxing skill level

	1	2	3	4	5

1 is Begginer, 5 is Advanced

This is a fill in the blanks field. Please add appropriate blank fields and text.

Interested in Competiting?

Membership type

List below the following reasons you decided to join this boxing program? (Examples : Strengthening upper- body and core. Boosts endurance. Improving hand-eye coordination, competing, confidence etc. )

Emergency Contact & Health Insurance Information

Important Notes · Dress appropriately. · No food or drink in the Boxing club ( only water ). · Keep the club clean. · The club organizers (Coaches) reserve the right to ensure the talents of all participants by categorizing in proper weight class to balance teams. · Fee: $75 a session for single sessions ) if you want to save money we have a monthly membership program 2-4 days a week programs Included in the fee, Boxing wrap ( to protect hands . Open Gym is a free workout day

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Area CodePhone Number

Does you have any allergies, breathing conditions , or medical conditions injury history that would limit high level activtiy?

Please describe

Release of Liability Although the safety of all sport activities is the primary concern, indoor sport activities at Rise and Shine boxing Community may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against the Rise and Shine Boxing and the persons in charge.

I have read and agree to the above conditions

Confirmation E-mail

Signature