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Juniors Registration
"
*
" indicates required fields
How many participant/s will you be registering?
*
One
Two
Three
This form can be completed for up to three participants doing the same number of sessions each week. If your are registering more than three participants, or they are attending a different number or sessions for the term, please complete a form for each child you would like to register.
How many sessions per week will the participant/s be attending?
*
One
Two
Please select which days will you be attending the program:
*
Tuesday 3.30pm - 4.15pm
Thursday 3.30pm - 4.15pm
Price:
Payment is made for the 8 week term with cost dependent on how many sessions per week.
Name of participant:
*
First
Last
Name of second participant:
*
First
Last
Name of third participant:
*
First
Last
Has the participant/s attended our program before
*
Yes
No
Parent / Guardian
*
First
Last
Phone
*
Email
*
Are you the emergency contact of the participant/s?
*
Yes
No
Emergency Contact
*
First
Last
Phone
*
Email
*
Credit Card
*
First Name
Card Details
CrossFit Juniors Program (Term):
*
Price:
$ 0.00
Name
This field is for validation purposes and should be left unchanged.
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*
" indicates required fields
Name
*
First Name*
Last Name*
Phone
Email*
*
Comments
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