Injury Report

Injury Report & Class Hold Request

Use this form to report an injury or illness requesting a class hold while unable to attend class.

All Requests must be confirmed! Maximum Class hold is 6 weeks.

A Doctors Note is required to hold a class spot or Removal from Class due to Injury!

Today's Date

A Doctors Note is required for a Class hold or Removal from class due to Injury!

I do not have a Drs. Note yet and will submit it when I receive it.

I do have a Drs. Note and I am attaching it to this form.

Upload Drs. Note

Upload supported file (Max 15MB)

If my child's class is being held, I agree that I will notify Rebounders with the expected Return Date.

Thanks for submitting!

We will contact you to confirm discuss your Injury and Membership.