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Ealing Gymnastics Trial Registration Form
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Email
*
Your email
First name
*
Please note, all questions are about your child
Your answer
Last name
*
Please note, all questions are about your child
Your answer
Date of birth
*
Please note, all questions are about your child
MM
/
DD
/
YYYY
Gender
*
Please note, all questions are about your child
F
M
Address Line 1
*
Your answer
Address Line 2
Your answer
Town
*
Your answer
County
*
Your answer
Post Code
*
Your answer
Country
*
Your answer
Please provide any relevant details about medical conditions, disabilities, chronic illnesses or behavioural disorders.
*
Please note, all questions are about your child
Your answer
Emergency contact number
*
Your answer
Parent First Name
*
Your answer
Parent Last Name
*
Your answer
How did you hear about us
*
Your answer
Past experience in gymnastics
*
Your answer
Please tick the days you are available to attend
*
Wednesday
Thursday
Sunday
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A copy of your responses will be emailed to the address you provided.
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