Child's Name (If multiple please add all names in the text box below) *

Parent/Guardian Name *

Parent/Guardian Mobile *

Email Address *

Mobile Number *

Address *

Date of Birth *

Please list any medical conditions, medications, allergies or injuries we should be aware of

I confirm I am physically fit enough and medically able to participate in this training. I accept that I take part at my own risk and that the organisers cannot be held responsible or liable for any personal accident, injury, loss or damage to personal effects that may arise as a result of my participation. *

I consent to the use of my name, image and also my performance in events, at any time, to promote JORG by any form of media. *

Please note there is $10 cash fee for casual sessions please bring along with you to your session.