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Please fill in all the information below

Athlete's full name*

Athlete's date of birth*

Day

Month

Year

Athlete's medical history we need to be aware of:

Parent/Gradian's full name*

Contact mobile number*

Contact email address*

What would you like a free trial for?*

CheerSPORT

Tumble

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Select which gym location is closest to you?*

Central Auckland (Mt Roskill)

West Auckland (Henderson)

Referral - if you have been referred by a friend please provide the friends name:

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