Rathbone ABC community boxing registration form

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Please answer the following questions BEFORE boxing with us. We have to ask certain questions to complete our reporting as a condition of the funding.

Participant name *

Participant age *

Postcode *

Ethnicity *

Indian

Pakistani

Bangladeshi

Chinese

Any other Asian background

Black Caribbean

Black African

Any other black or black British background

White and Black Caribbean

White and Black African

White and Asian

Any other Mixed background

White English, Scottish, Welsh or Northern Irish

White Irish

White Gypsy or Irish Traveller

Any other White background

Arab

Any other ethnic group

Gender (please note, this form is used for multiple programmes)

Female

Male

Non-binary

Prefer to to disclose

Clear selection

Contact email address *

Contact phone number

Emergency contact name *

Emergency contact number *

List/explain any physical health conditions that affect you exercising (please make a coach aware at the beginning of the session)

List/explain any mental health/neuro conditions we should know about

Participant declaration: I understand that all forms of exercise carry some risk of injury, and that these risks are reduced by following the coach’s instructions. I confirm that I take part in these non-contact boxing sessions at my own risk and will tell the coach before or during the session about any injury, illness, medical condition, or concern that may affect my ability to participate safely.

I understand that photographs and videos may be taken in the session to advertise the sessions and satisfy funder requirements. If I do not want to be in these I will inform the coach at the start if the session.

Tick to accept

Required

We offer various sections of the community the opportunity to box for free. If your school or group would be interested in a course of free sessions in our Wimbledon gym (due to open autumn 2026) please email us at rathboneabc@gmail.com Alternatively tick below if you would like us to contact you when we have news of the following:

Free non-contact sessions for children and young people

England Boxing registered Amateur (Olympic style) boxing (11-39 year olds)

Women's only session

Older adults (over 65)

Parkinson's Boxing

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