Free Trial Registration Form

Childs Name *
Childs Name
Parent/Guardian Name *
Parent/Guardian Name
Address *
Address
Emergency Contact Name *
Emergency Contact Name
Please select from the following locations
Preferred Class Day/s *
Children’s Physical Activity Readiness Questionnaire (PAR-Q) Screening Form *
The purpose of this form is to provide us with specific details of your child’s medical history and general health information so that we can avoid any risk of injury or illness. Completion and submission of this questionnaire is mandatory before your child is permitted to participate in any Fitletica program. Has your child ever experienced any of the following. Please tick if applicable:
Terms and Conditions/Consent *
Please click link on bottom of page for full Terms and Conditions.