The Legion Community Club

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D.O.B

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Learning Disability
Physical Disability
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Mental Health
Developmental Disability
Sensory Disability
Other

Please give as much details as possible to help us understand how we can help you

Please tell us any health conditions and medications in-case of an emergency

(Adults Only if happy to share the following information) Please tick which best describes your current situation. This is for data use to help us better understand how we can help our members and implement future services in the coming future

Employed
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Student
Other
Carer
Food poverty
Energy poverty
Supporting a disabled Adult or Child
One parent family
Suffering Stress or Anxiety

User Agreement

By continuing, you agree to our Privacy Policy and Terms of Service. You are further confirming you understand the data protection and safegaurding policies before submitting this form and how they effect you and your child, if filling on behalf of a child.

Please note for a child to become a member the parent must also fill out a membership form, if the child is under 16. This is to ensure every parent has read and understands the parental code of conduct, consent for photography and consent to travel away from the club when supporting or competing in a boxing tournament.