Learner Registration Form

Complete and submit our registration form

Certain fields are required, please fill in as much of the form as possible.
 
Your gender is required
 
Fitness Declaration and Safety Agreement
Please tick any that apply to you






 
I declare to the best of my knowledge that I know of no reason why I should not participate in Exercise classes. I acknowledge that there are risks inherent in physical exercise. I agree to abide by the verbal or written instructions given to me by the Tutor and will observe any written notices regarding safety whilst training.
Declaration must be confirmed
 
Person to contact in case of emergency
 
 
 
  YMCA Approved and REPs Recognised
YMCA Awards