LIVE private booking cmsauk.com

Booking form
I would like to book a free trial session

Yes
What sport are you interested in? *

Fitness Netball Football
Select venue
Number of children you are booking for The Bushey Arena
I would like to book the following course:

Saturdays 9-9.45am
Bushey Arena Number of children
Cost
Number of children you are booking for Woodhouse College
I would like to book the following course:

Sundays 10.30-11.15am
Woodhouse Number of children
Cost
Number of children you are booking for Finchley
I would like to book the following course:

Wednesdays 5-6pm (Years 3-6)
Finchley Number of children
Child details
Childfullname *
Child name *

First Last
Date of birth *

Day Month Year
Date
School year *
School year *
School *
Gender *
Sport
If you would like to book for more than one child, please place 2 bookings. You can pay for them in one bank transfer.

Health Questions: Does your child have/has your child ever had any of the following:

Yes

No

High or low blood pressure

Elevated blood cholesterol

Diabetes

Chest pains brought on by physical exertion

Childhood epilepsy

Dizziness or fainting

A bone, joint or muscular problems with arthritis

Asthma or other respiratory problems

Any sustained injuries or illnesses

Any allergies?

Is your child taking any medication?

Has your doctor ever advised your child not to exercise?

Is there any reason not mentioned above why any type of

physical activity may not be suitable for your child?

If you have answered yes to any of these questions, please provide details here:
Please enter n/a if there is no medical information
Does your child participate in other physical activities out of school?

Yes No
If yes, please indicate activity/activities:
Has your child participated in fitness/gymwork in the past?

Yes No
How motivated is your child on a scale of 1-10?
(10 being the highest motivated)
How motivated is your child to do fitness on a scale of 1-10?
Does your child have any favourite hobbies?
Please tell us any other information about your child’s lifestyle/ personality that you feel may be helpful prior to commencing sessions:

Add child 2 +
Childfullname
Child name

First Name Last Name
Date of birth

Day Month Year
Date
School year
School
Gender
School year
Sport

Add child 3 +
Childfullname
Child name

First Name Last Name
Date of birth

Day Month Year
Date
School year
School
School year
Gender

Health Questions: Does your child have/has your child ever had any of the following: *

Yes

No

High or low blood pressure

Elevated blood cholesterol

Diabetes

Chest pains brought on by physical exertion

Childhood epilepsy

Dizziness or fainting

A bone, joint or muscular problems with arthritis

Asthma or other respiratory problems

Any sustained injuries or illnesses

Any allergies?

Is your child taking any medication?

Has your doctor ever advised your child not to exercise?

Is there any reason not mentioned above why any type of

physical activity may not be suitable for your child?

If you have answered yes to any of these questions, please provide details here: *
Please enter n/a if there is no medical information
Does your child participate in other physical activities out of school? *

Yes No
If yes, please indicate activity/activities:
Has your child participated in fitness/gymwork in the past? *

Yes No
How motivated is your child to do fitness on a scale of 1-10?
Does your child have any favourite hobbies? *
Please tell us any other information about your child’s lifestyle/ personality that you feel may be helpful prior to commencing sessions: *
Sport

Add child 4 +
Childfullname
Child name

First Name Last Name
Date of birth

Day Month Year
Date
School year
School
School year
Gender
Sport

Add child 5 +
Childfullname
Childname

First Last
Date of birth

Day Month Year
Date
School year
School
School year
Gender
Sport

Contact Details
Contact details
Parent/Guardian's Name *

First Name Last Name
E-mail *

Address *

Address Line 1
Address Line 2
City	State / Province
Post Code	Country

Contact Number *
Child Medical Information *
Please enter n/a if there is no medical information
Emergency contact details
Emergency Contact Name

First Name Last Name
Relationship to Child
Enter sibling discount code here
Sibling discount
Total cost
Payment should be made by bank transfer to:

Account Name: CMSAUK LTD
Sort Code: 09-01-29
A/C: 20587345
Ref: Childs Full Name

Payment must be received at least 1 week before the start of the course/camp.

Alternatively payment can be made in person via debit or credit card, Apple pay or Android pay. Please note these are all subject to a 1.75% handling fee.
Alternatively we are happy to accept childcare vouchers for all Moriah JDS activities through the school.
In clicking book now, I (the parent/guardian of the child) affirm that I have read this form in its entirety and I have answered the questions accurately and to the best of my knowledge.

I understand that my child is responsible for monitoring him or herself throughout the activity and should any unusual symptoms occur, my child understands the importance of informing the instructor immediately.

In the event that medical clearance must be obtained before my child's participation in an exercise session, I agree to contact the GP and obtain written permission prior to the commencement of the exercise activity, and that the permission is given to the instructor.

I (the parent/guardian of the aforementioned child) accept responsibility for dropping off and collecting the aforementioned child for the start and end of the fitness session.
In order for us to send you marketing emails, we need your permission to do so. Please tick below if you would like to be on our mailing list.

I consent to email marketing. (We keep our email communications to a minimum.)

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