KIDS FITNESS CLUB ON-LINE REGISTRATION
Email address *
Child's Full Name *
Your answer
Age *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Weight *
Your answer
Height *
Your answer
Parent/ Guardian Contacts
Full Name *
Your answer
Relationship *
Handphone / Contact Number *
Your answer
Emergency Contact other than Parent / Guardian
Emergency Contact Name *
Your answer
Emergency Contact Relationship *
Your answer
Emergency Contact H/P *
Your answer
Medical Information
Parents have the obligation to disclose significant, medical, physical or behavioral issues at the time of the child's registration and update the above information whenever necessary. *
Please state here (if Yes) :
Your answer
I (parents/ guardian) agree that Kids Fitness Club may collect, use and disclose my child's personal data, as provided in this application form as a result of registration, for the said purpose in accordance with the Personal Data Protection Act 2012. *
Required
Disclaimer
I understand that Kids Fitness Club will take every reasonable precaution to ensure the safety and health of my child and the participation of my child in events organised by Kids Fitness Club is my own responsibilty. I shall not hold LWE Kids Fitness Club responsible for any untoward incidences and accidents that should arise. *
Required
A copy of your responses will be emailed to the address you provided.
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