Professional Documents
Culture Documents
_________________________________________________________________
Personal Details:
Gender:
Address: __________________________
Male Female
Suburb: ____________________
Name: ___________________ Postcode: ________
Surname: ________________
Phone: ____________________
Date of Birth: _____________ Mobil: ____________________
Email: ______________________________
Emergency Contact Name: _________________________
Emergency Contact Phone: ____________________
Occupation: ____________________
Medical History:
Tick the box or type yes if any of these statements apply to you:
Heart Conditions
Family history of stroke
Arthritis
Epilepsy
High/Low blood pressure
Diabetes
Asthma
Are you willing to travel to different suburbs in the west for Boot
Camp?
_______________________________________________________
Date:
__________________________
___________________________
Trainers Name:
Trainers Signature:
__________________________
___________________________