Join - Empower Wrestling

Registration Form

Interested in reaching your full potential? Fill out our application form for classes. and let your journey and training begin.

Student Details

First Name

Last Name

Gender

D.O.B

Class Interested In

Contact Details

Datime Contact Number

Mobile

Address

House /Building No.

Address

Address 2

Town/City

County

Postcode

Parent / Guardian Details

Required for students under 18.

Contact Numbers

Address As Above (if no please enter address below)

Yes No

Other Details

Does you or your child have any medical, physical or learning disabilities

Yes No

Emergency Contact Details

In an emergency the parent/guardian will be the first point of contact. Should you be unreachable, however, Please provide us with a relative or close friends details.

Disclaimer:
By clicking send you agree to be contacted by a member of our team regarding participating in our wrestling classes.
In line with Data protection Laws we will only keep your details for as long as you participate in weekly classes as set out in our terms and conditions.
As required by GDPR regulations We will not sell or use your data for marketing purposes.