Teens Health Questionnaire

* Indicates required field

Name of child *

First

Last

Date of Birth (Child) *

Name of parent/guardian *

First

Last

Emergency Telephone *

Email *

Address *

Please give details of any health conditions or anything else we may need to know to best care for your child: *

If your child is going to the Teens class (approx 12 - 18 years old) what other sports are they playing an what is their training/practise/games schedule? *

Will your child be making their own way to and from the class? *

Yes No

Data Protection Act 1998
It is traditional in our community for both our adult and child members to have their achievements recorded. We often post videos or pictures to our website and Facebook page of new accomplishments and to recognise our athlete's efforts.
Please sign below to allow us to permission to take and use your child's photograph to post on www.crossfitavon.com and/or for promotional literature.

By typing your name in this box you are digitally signing this document. Your typed name carries the same weight as a paper signature.

Name: *

Date *

Note to Parent/Guardians
Your child’s safetyis paramount to our coaches, and it is with this focus we need your help. Below are some rules that we must enforce as a CrossFit Community to best protect your child; please:

Teens – Let us know if you are happy for your child to make their own way to and from class
If you choose to stay and watch the class please do not coach your child during the class.
Immediately notify the head coach if you see anyone outside the gym who looks suspicious
Children with disciplinary problems: first warning-free of consequence, second warning-sit out the first two minutes of the session, third warning-go to the parent.
All classes need to be booked and paid for on our online booking system before turning up.
A New Child Athlete form, signed by a parent or legal guardian, is required for each child before he or she is allowed to participate in a class.
Ensure your child has a bottle of water, or a bottle that can be filled up at the gym.
Ensure your children are wearing clothes appropriate for running, jumping, rolling, pulling, swinging, climbing, crawling, throwing, and being upside down.
Finally, please make the head coach aware of any special needs for your children that may facilitate their individual safety, learning, and growth (i.e., medications, illness, physical or mental limitations, injury, sports, etc.).

By typing your name in this box you are digitally signing this document. Your typed name carries the same weight as a paper signature.

Name *

Date *

Submit

Teens Health Questionnaire

Where to find us

Contact Us

Quick contact

Social Media