Restore Boxing Program Registration Form

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Welcome to the Restore Program!

We’re privileged to have you here as you take the first step to register your interest! Our program is all about creating a safe space just for women to come together, experience the healing benefits of boxing, and receive therapeutic support. It's a chance to heal, connect, and build community with others who understand.

Please take a moment to answer the questions below—this should only take about 5 minutes. Please be aware that some of the questions relate to domestic abuse.

Name? *

Age *

Phone Number

Have you ever boxed before? *

Yes

If yes please give details of when, how often and where. *

Have you experienced domestic abuse? *

Yes

Are you currently in an abusive relationship? *

Yes

I agree to receive communication regarding future events and sessions. *

Yes

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