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*
AboriginalTorres Strait IslanderNeither
YesNo
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.
YesNo
I give permission for my child to participate in the 6 Week Boxing Program.I understand that I am responsible for my child at the conclusion of each session and will either collect my child or sign below to confirm that they can leave independently.If my child is permitted to leave independently, I accept full responsibility once the session has ended.I understand that participation is subject to following program rules and safety guidelines. If my child does not follow these expectations, they will be removed from the program.I confirm that my child is medically fit to participate in physical activity and have disclosed any relevant medical conditions.In the event of illness or injury, I consent to staff seeking appropriate medical assistance for my child. I understand that I am responsible for any associated medical costs.
Please confirm below if you give permission for your child to leave independently at the conclusion of each session. *
Parent Carer Name*
Signature*

Clear
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: