GRASSROOTS & JUNIORS

AGES 11 - 17
REGISTRATION FORM

Basic information

(to be completed by parent or guardian)

Childs first name

Childs last name

Childs date of birth

Day

Month

Year

Age today

Height (cm)

Please select your primary ethnicity (list below is in no particular order)

Level of fitness

Gender

Childs School

Parent / Guardian Email

Parent / Guardian Phone

Please check your email and phone number are correct

Street Address

City

County

Postcode

Emergency contact

Emergency name

Emergency Phone

Emergency Email

Boxing classes with sparring

Do you consent to sparring using protective equipment as per England boxing guidelines?

I give permission for my child to take part in training and boxing-related activities, including sparring, fitness training, padwork, bagwork, and (if selected) competition under England Boxing rules.

I understand the risks involved in boxing and confirm my child is fit to participate.

Medical Consent

Please identify any medical conditions, disabilities, allergies, or injuries we need to know about

Please provide further details of any medical conditions

Cuts/graze - cleaned and plaster or dressing applied:

Ice packs used to treat minor injuries:

Whilst we will make every effort to contact you or your emergency contact in a medical emergency, if this is not possible, your permission is required for us to take appropriate action, including taking your child to hospital for treatment

Additional Notices

West Herts ABC recognises the need to ensure the welfare and safety of all children. We will take steps to ensure that photographs, images and footage are used only for appropriate purposes, including promoting the work and activities of West Herts ABC & Educational Support CIC.

Additional notes i.e which sessions you are interested in and other relevant information, please say here...

Code of conduct

Show respect to coaches, members, and officials
Train safely and responsibly
Follow England Boxing and club rules
Understand that parents/guardians are not allowed to remain in the gym during the sessions

My child agrees to the code of conduct conditions.

Policies & Safeguarding

West Herts ABC & Educational Support CIC is committed to safeguarding and promoting the welfare of all children and young people. We have clear policies in place covering behaviour, safety, supervision, use of facilities, and appropriate communication, including photography and social media. All staff and volunteers are expected to uphold these standards to ensure a safe and supportive environment at all times.

I confirm that I have read and understood the club's safeguarding approach and agree to abide by the club's policies and procedures.

I have completed this booking form as honestly and accurately as possible, I understand that West Herts ABC can only provide the best service based upon the information I provide. If my child has any special requirements, I have added this information in the additional comments section above.

I have read the notices page.

By registering your interest and submitting this form you give consent for your child to take part in body sparring.

Parent / Guardian name

Please note:

Parents and guardians are not permitted to sit in or observe sessions. For safeguarding reasons, all sessions operate on a drop-off and pick-up only basis.

All Grassroots and Junior sessions run for one hour.

AGES 11 - 17 REGISTRATION FORM