Aldershot Taekwon-Do Enrolment Form

Student Registration Form

Please fill out the form carefully for registration from September 2020 onward
Student Name*

First NameLast Name
Birth Date

MonthDayYear
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact E-mail*
example@example.com
Mobile contact number*

Area CodePhone Number
Emergency contact name*

First NameLast Name
Emergency contact mobile *

Area CodePhone Number
Emergency contact landline

Area CodePhone Number
Medical information - has the applicant/student been diagnosed with any of the following
Additional Comments relating to medical history
How did you find out about us?
What are you reasons for starting a Martial Art?*
All members and potential members (trial students) agree to and abide by the following

1. Students rules click here

2. Our terms and conditions click here
Please verify that you are human*
Signature*
Should be Empty:

Student Registration Form