After School 6 Week Boxing Program Term 1

After School 6 Week Boxing Program Term 1 - 2026

Parent/Carer Permission Form
Please complete the registration form. The information we collect is required to manage risk, provide reasonable care and administer your child's involvement in the program. Information is kept confidential and only provided to those involved in the activities. (eg. First Aid, Coaches, Instructors and Kids & Teens in the Valley.

Please note, there are limited spaces so we will do our best to accommodate everyone.
Participants Name

First NameSurname
Grade
Age
Date of Birth

MonthDayYear
Date
Gender
School
Parent/Carers Name

First NameSurname
Mobile No.
Format: 0000000000.
Email
example@example.com
Address
Do you or any of your family identify as Aboriginal and/or Torres Strait Islander?
I give consent for group photographs to be taken and used by Kids & Teens in the Valley. No names will be published in social media posts or newsletters.
EMERGENCY CONTACT/AUTHORISED PERSON:
Name
Relationship to Child
Mobile No
Format: 0000000000.
MEDICAL INFORMATION
Please list any medical or physical conditions below to help us keep things safe and supportive.
Please let us know of any behavioural or support needs that would help us create a safe, inclusive, and positive experience.
Would you like to know about other Kids & Teens in the Valley programs and activities happening throughout the year?
CONSENT
Please confirm below if you give permission for your child to leave independently at the conclusion of each session.
Parent Carer Name
Signature
Date

DayMonthYear
Date
Any Further Comments
If you have any questions, please email us on bookings@kidsinthevalley.com.au
Should be Empty:

After School 6 Week Boxing Program Term 1 - 2026

EMERGENCY CONTACT/AUTHORISED PERSON: