Announcement
  • UPCOMING EVENTS – Power Camp October Holidays [Oct 11th to 13th & Oct 18th to 20th] | Halloween Monster Mash 2021: October 29th, Friday – Sign your lil monster up for a SPOOKKYYY good time with us!


Kindly complete this form to register your interest for our Power Kids on Wheelz session.

We generally respond to enquiries within 24-48 hours. If you have not received an email from us after this time, please check your junk mailbox in case this email is incorrectly filtered.

Name of Parent / Guardian completing this form*
  • – Title –
  • Mr
  • Ms
  • Mrs
  • Prof
  • Dr
– Title –
Field is required!
Field is required!
First Name
Field is required!
Field is required!
Last Name
Field is required!
Field is required!
Contact No.
Field is required!
Field is required!
E-mail
Field is required!
Field is required!
Child’s Name*
Child’s First Name
Field is required!
Field is required!
Child’s Last Name
Field is required!
Field is required!
Child’s Date of Birth
Select a date
Field is required!
Field is required!
Child’s Age
Age
Field is required!
Field is required!
DAY OF SESSION
Field is required!
Field is required!
TIME OF SESSION
Field is required!
Field is required!
Residential Address
Residential Address….
Field is required!
Field is required!
Please indicate your package
Field is required!
Field is required!
Do you have a preferred Power Kids trainer?
Do you have a preferred Power Kids trainer???
Field is required!
Field is required!
How did you hear about us?
Field is required!
Field is required!
Others…
Field is required!
Field is required!

Waiver Release:

I hereby give my consent for my child participation in the class conducted by Power Kids Gym and hereby absolve and release Power Kids Gym from any and all liability for any injuries or damages that may be incurred by my child in the activities conducted by Power Kids Gym.
I have read and agree to the waiver release.
Field is required!
Field is required!