Provide details of any medical,
physical or intellectual condition that may have a bearing on the Gymnast’s
ability, safety or behaviour in class
Is the Gymnast on any medication of
which we should be aware? If so, describe:
Does the Gymnast suffer from any
allergies (ie: asthma, bee stings etc)?
If so, please ensure that the Gymnast has sufficient allergy medication
with him/herself and is able to self-administer this medication when necessary.
Family Doctor’s Name/Surgery:__________________________ Contact Number ______________
Name and signature: __________________________________date: / /