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Personal Fitness Training
Full Name
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First Name
Last Name
Birthday
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Month
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Day
Year
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Gender
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Female
Male
Height
Weight
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
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Phone Number
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Area Code
Phone Number
Details of Parents
For Applicants below the age of 18 years.
Name of Father
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First Name
Last Name
Marital Status
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Single
Married
Divorced
Father's Phone Number
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Area Code
Phone Number
Father's E-mail
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Name of Mother
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First Name
Last Name
Marital Status
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Single
Married
Divorced
Mother's Phone Number
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-
Area Code
Phone Number
Mother's E-mail
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Health Declaration
Health Conditions (If any) [Please indicate if you/your child suffers from any medical conditions/allergies that the academy/coach should be aware of (including any current medication)
Health Details
Allergies
Consent
I agree to me/my child taking part in the activities of the Company.
I confirm to the best of my knowledge that I/my child *do/does* not suffer from any medical condition other than those listed above.
I confirm that the Company will not be held responsible for any injury, loss or damage cause by or during attendance on any of the company's training sessions, tournaments or activities.
The Company has the right to not accept participants that are self- injurious or tend to cause injury to other participants.
I consent to photos and videos taken of me/my child during trainings by the Company for marketing purposes.
Signature of Parent/Applicant
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Date
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Month
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Day
Year
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