Announcement
  • Summer Camp Dates are out! Grab a friend and sign up to enjoy 5% BUDDY discount! 😀


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 –
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First Name
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Last Name
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Contact No.
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E-mail
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Child’s Name*
Child’s First Name
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Child’s Last Name
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Child’s Date of Birth
Select a date
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Child’s Age
Age
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CLASS OPTION
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TIME OF SESSION
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Residential Address
Residential Address….
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How did you hear about us?
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Others…
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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.
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Field is required!