What is the first name and last name of the Junior Gymspace user this medical questionnaire is being completed for?

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* 1. What is the first name and last name of the Junior Gymspace user this medical questionnaire is being completed for?

What is the Junior Gymspace user's membership number?

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* 2. What is the Junior Gymspace user's membership number?

Please state the name and relationship to the Junior Gymspace user of the person completing this form (must be 18 years or above)

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* 3. Please state the name and relationship to the Junior Gymspace user of the person completing this form (must be 18 years or above)

Which site does the Junior Member intend using?

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* 4. Which site does the Junior Member intend using?

Does the Junior Gymspace user have any medical conditions / injuries or allergies that we should be made aware of? If so, please give details below.

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* 5. Does the Junior Gymspace user have any medical conditions / injuries or allergies that we should be made aware of? If so, please give details below.

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