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Individual waitlist REGISTRATION
*
Indicates required field
Full Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Email
*
Indoor Netball League
*
Wednesday Night - Mixed 6 Aside
Thursday Night - Mixed 6 Aside
In Case of Emergency
*
Name
Emergency Contacts Number
*
Do you have any medical conditions we need to be aware of?
*
Yes
No
If yes please provide all details we need to be aware of including any medications:
*
Do you have any injuries to Joints or Muscles?
*
Yes
No
If yes, please provide details of injuries:
*
Informed Consent
I hereby acknowledge that the information provided above regarding my health is to the best of my knowledge correct. I will inform you immediately if there are changes to my health status.
*
I Agree
Disclaimer
I acknowledge that participating in physical activity carries a risk and I accept all responsibility for that risk.
*
I Agree
I have read and agree to abide by Kumeu Gym's Indoor Netball Rules
*
I Agree
I have read and agreed to abide by Kumeu Gym's Code of Conduct
*
I Agree
Submit
Indoor Netball Rules
Code of Conduct
Home
SMART Training
Memberships
Free Week Trial
what we offer
EVOLT 360 BODY SCANNER
Group Fitness Classes
Self Defence Registration
SPONSORSHIP
About us
Our Crew
Gallery
Contact Us
Indoor Netball