Child's Surname First Name

Please indicate venue you were looking for your child to attend :

Address 1 Address 2
Town Post Code
Mobile Tel No
Date Of Birth Email


School / Playgroup attended
Please indicate if your child has any previous Gymnastics experience.
Yes No
Do you consider yourself to have a disability?
Yes No
How did you become aware of Acorn Gym Club?
In order to help the club monitor its membership can you please select one of the following options to identify your ethnic group:
White Mixed
Asian Or Asian British Black Or Black British
Chinese Other Athenic Group


Any important contact or medical information in the event of an accident (Medical Conditions) :

We really value your support in promoting the sport of gymnastics, please can you confirm you give permission for :
(a) your child to be included in photos/videos taken at the gym by an appropriate DBS checked official?
Yes No
(b) photos/videos taken at the gym to be published (club facebook, posters, fliers etc).
Yes No
(c) photos/videos taken at the gym to be published by 'Gymnastics Mentor'; currently under development at our classes. For example, common faults (for skills) which are detected in the early learning stages of gymnastics, when recorded and utilised, are an extremely useful resource for the 'Gymnastics Mentor' program.
Yes No
We do our best to notify parents at all times that media has been published (within a week), but do not guarantee that we will reach you.



Authorisation: I give permission for my child to participate in all club activities. Parents are warned that although we will take every step to ensure safety of gymnasts every sporting activity comes with a small risk of injury. In such an event we cannot be held liable unless negligence is proven. In the event of accident I give permission for the above child to be given medical treatment if necessary. I have read the code of conduct document for children and parents.

Please confirm that you have read the "welcome info" document and will adhere to the code of conduct.

Parents / Guardians Name

Signature Parent / Guardian