Kids Eastside Boxing Term 1, 2025 Sign up Form

Eastside Little Boxers Age 5-8 Years Monday and Wednesday 4.00pm - 4.45pm

Eastside Fundamentals Age 9-13 Tuesday, Wednesday and Thursday 4.45pm - 5.45pm

Childs First Name

Childs Last Name

Childs Date of Birth

Parent/Caregiver Email

Parent/Caregiver Phone Number

Address

Emergency Contact

Emergency Phone Number

Medical Health - Is your child on any medications?

Does your child have any serious medical conditions

Does your child have a disability?

Please list any relevant medical information regarding your child that Eastside Boxing coaches may need to know

Privacy and Waiver: You will need to supply your personal information to the Grassroots Trust Velodrome in respect of this application. Your privacy is important to us. Your personal information is not shared with outside parties. The contact details you provide will only be used in relation to your use of the Grassroots Trust velodrome and to send you relevant information. If you would like to update the information that you have provided, please send an email via the Grassroots Trust Velodrome’s website with the desired amendments. The Grassroots Trust Velodrome does not sell, trade, or otherwise transfer outside parties your personally identifiable information. We may use non-identifying and aggregate information to better deliver out services. To prevent unauthorised access, maintain data accuracy and ensure the correct use of information, we have put in place appropriate physical, electronic and managerial procedures to safeguard and secure your personal information. Should you have questions or concerns about this privacy statement, please contact us via the Grassroots Trust Velodrome’s website. I also understand there are certain hazards, and risks involved with this activity which can cause personal injury and property damage. I further understand that the Grassroots Trust Velodrome does not assume responsibility for any such personal injury or property damage.

Eastside Boxing Rules:Like most gym we have a set of values and guidelines to ensure that safety is paramount. · Shake your trainers hand and those training with you – Introduce your self. · There are to be no spectators inside the centre of the velodrome, if you would like to watch your child please take a seat in the area above the boxing ring. · For Little Boxers we welcome you to take your child down to the trainers for their first session to familiarise themselves with our trainers · All payments are completed at velodrome reception · Please ensure you are wearing correct enclosed footwear while training · Please stay of velodrome gym unless your membership allows you train in this area. · No swearing or bullying will be tolerated at Eastside Boxing. Eastside Boxing Rules - I have read and agree to these rules for myself and my child.

I give parental permission to the capture and use of media such as photos and videos for marketing and promotional purposes associated with Eastside Boxing and Grassroots Trust Velodrome only.

I give parental permission for First Aid to be adminsiter to my child if required whilst at the Grassroots Trust Velodrome at Eastside Boxing Classes

Address

Thank you for signing up for Term 1, 2025 Kids Boxing with Eastside Boxing. Payment is required to secure your place. Payment needs to be made no later than January 17th 2025 and can be paid at Velodrome reception or via online banking. BNZ 02-0316-0416117-02. Please put you childs name as reference and Kids Boxing as the Code. Many thanks!

For all enquiries please contact reception:
Phone: 0800 VELODROME
or 07 823 1421
reception@velodrome.nz

Grassroots Trust Velodrome
15 Hanlin Rd
Cambridge 3283
Waikato
New Zealand

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Kids Eastside Boxing Term 1, 2025 Sign up Form

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