Walton Volleyball Club Registration Form
Please complete this form to register with the club. It should take just a few minutes to fill in.
Email address *
First Name *
Your answer
Surname *
Your answer
Mobile Phone Number *
Your answer
Address *
Your answer
Gender *
Age *
Please select your age range
Volleyball Interest *
Please indicate the level of involvement that interests you at Walton Volleyball Club. Tick all that apply to you.
Required
PAR Q (Physical Activity Readiness Questionnaire) *
If you answer YES or UNSURE to any of these questions then we recommend that you seek advice from a medical professional before significantly increasing your levels of physical activity.
YES
NO
UNSURE
Has your doctor ever diagnosed you with a heart condition or stated that you should only undertake exercise recommended by them?
Do you feel pain in your chest when you undertake exercise?
Do you feel pains in your chest when you are NOT undertaking physical activity?
Do you ever suffer from dizziness or a loss of consciousness?
Do you have bone or joint problems that are made worse when you move?
Are you currently taking any form of medication that could affect physical activity?
Do you know of any reason why you cannot perform physical activity?
Further Details
Please inform us if there is anything you think we should know about regarding your physical readiness to play volleyball.
Your answer
Communication Preferences *
We would like to keep in touch with you. Please tick the methods that you are happy for us to use.
Required
Emergency Contact *
Please add contact details of someone we can get in touch with in case of emergencies.
Your answer
Thank you for completing this form and welcome to Walton Volleyball Club!
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