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New Boxer Registration
South Derbyshire Boxing Academy
England Boxing Affiliated Club
Boxer Details
Full Name
Date of Birth
Gender
Email
Address
Postcode
Mobile Number
Emergency Contact Name
Emergency Contact Number
Parent / Legal Guardian Details (if boxer is under 18)
Full Name
Relationship to Boxer
Address (if different)
Contact Number
Email
Medical Information
Do you have any pre-existing medical conditions, injuries, or health issues that the coaches should be aware of?
No
Yes
Are you currently taking any medication?
No
Yes
Confirmation
I confirm that the above medical information is accurate and complete.
Participation Declaration
I understand that boxing is a physical contact sport and carries a risk of injury. I confirm that I (or my child) am fit to take part in boxing training and activities and will inform the club of any changes in medical condition.
Photography & Media Consent
From time to time, South Derbyshire Boxing Academy may take photographs or video recordings during training sessions, competitions, or events for coaching, promotional, and safeguarding purposes.
Please tick one
I consent to photographs and video being taken and used by the club (including on social media and the club website).
I do NOT consent to photographs or video being taken of me / my child.
Data Protection
All personal information will be stored securely and used only for club administration, safeguarding, and England Boxing registration purposes, in line with UK GDPR and club policies.
Submit
