Participant Name: *

Parent/Carer Name:

If on behalf of young person under 18

Please use the email that you use to book sessions

Phone

Emergency Contact Name*:

Emergency Contact Phone*:

Gender (Biological at birth):

Male
Female

Age Today:

Date of Birth:

Previous boxing experience

None
A few classes
Boxercise
Regular training
Competitive boxer

Medical History:

Please provide as much information as possible on any outstanding or historical health concerns or injuries

Other Notable Information:

Please include anything that our coaches would benefit from knowing to make our classes better for you!

How did you hear about us?

Google Search
Facebook
Instagram
YouTube
Banner
Print Material
Wider Public Media
Word of Mouth
Website
Online Adverts

I consent to participate in sessions and accept the risks associated with boxing *

I declare that I have no outstanding health condition that may affect my ability to safely participate in training sessions and/or pose a risk to life *

I consent to the use of photography by Union Jab staff members for wider marketing If you do not consent for any reason, please make coaches aware during sessions so that you or the young person in your care is not included in any material.

This section pertains to parents/carers of those participating in Youth Boxing sessions. If you are over 18 years you can skip to the final question.

I declare that I have read and agree to abide by the spectator guidelines for Youth Boxing sessions (available online at unionjab.com).

I understand that I must not take any photos during any class for any reason. Only Union Jab staff members are permitted to photograph during a class.

I understand that other parents/carers may be present during a class within the designated spectator area.

I agree that I will at no point talk, shout, or attempt to coach the person I am supervising during the class and will remain seated throughout accordingly.

I agree to promote a hard-working environment by prompting any young person I am supervising to continue working hard during rounds, and to only rest/return for drinks during designated rest periods.

I am familiar with the Union Jab Safeguarding Policy and agree to forward any safeguarding concerns to the Designated Safeguarding Lead at christy@unionjab.com

Final declaration:

Boxing Training Disclaimer and Parental Consent for under 18's * * I understand that participation in the sport of boxing could include actions or tasks which might be hazardous. This agreement is to train with Union Jab under the instruction of their coaches which includes the correct and safe use of the gym equipment. I agree to release Union Jab from all liability, costs and damages which might arise from participation in above named activity. I have read, understood and agree to the information contained in this disclaimer and have by ticking the above Boxing Training Disclaimer given consent to taking part in Boxing Sessions with Union Jab

New Starter Consent Form

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