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

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

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

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

* 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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