Member Information
Tell us about yourself so we can set up your membership and ensure safe training.
Personal Information
Address
Emergency Contact
Who should we contact in case of an emergency?
Primary Emergency Contact
Health & Safety Screening
This information helps our coaching staff provide a safe training environment. Your answers are reviewed by our team and kept confidential. Please answer honestly — none of these answers will automatically prevent you from registering.
Do you have any medical conditions we should be aware of?
Are you currently under the care of a physician?
Do you have any physical limitations or injuries that may affect your participation?
Are you taking any medications that may impact your ability to exercise safely?
Detailed Condition Checklist
Check any conditions you currently have or have had in the past.
Do you have any allergies that our staff should be aware of?
Are you currently taking any medications that our staff should be aware of in the event of an emergency?
Photo / Media Consent
Gideon Boxing Gym may photograph or record members during training and events. Content may be used for promotional and educational materials, including the gym's website, social media, and print materials. Names are never used without separate permission. Consent may be withdrawn at any time by written notice to the gym.
Do you grant permission for Gideon Boxing Gym to use your photo and video likeness?
This choice is optional and will not affect your registration.
Intake Acknowledgment
I certify that the information provided in this registration is accurate and complete to the best of my knowledge. I agree to promptly notify Gideon Boxing Gym of any changes, including changes in my health status.