NOTE: You can use this form to register multiple members at once if they all share a single Main Contact Phone Number. If each member of the same household wishes to receive notification Text Messages to their own individual phone numbers, please submit the form 1 person at a time.
You should receive a confirmation email shortly after submitting your form. If the email has not arrived to your Inbox within 24 hours, please check your Spam/Junk folder. If the email is not present in either folder, your registration has not been sent - please return to this page and try again.
Select each club that you / your family train at. You may select more than one.
Home Address: Eircode:
First Name: Last Name: Date Of Birth:
DO YOU HAVE ANY LONG-TERM PHYSICAL INJURIES OR MEDICAL CONDITIONS (INCLUDING ALLERGIES)?
If YES, please give details (otherwise leave unchanged):
ARE YOU TAKING ANY MEDICATION AT PRESENT?
DO YOU HAVE ANY SPECIAL MOBILTY OR LEARNING REQUIREMENTS?
DO YOU HAVE ANY PAST CONVICTIONS RELATING TO VIOLENCE / ASSAULT?
Tip: Click the + button below to add another person. Click the - button to remove a person.