New Membership

Membership Registration

Hayashi-Ha Shitoryukai Karatedo Singapore
Your Details
Full Name (as in NRIC)*
First Name*
Last Name*
Date of Birth*

DayMonthYear
Race*

ChineseMalayIndianEurasianOther
Gender*

MaleFemale
Your Contact Details

These information will be used by us to contact you for club purposes.
Your Contact Number*
Your Contact Email*
example@example.com
Emergency Contact

In case of emergency will contact your listed emergency contact details
Emergency Contact Name*
Emergency Contact Number*
Emergency Contact Relationship*

Training Profile Information

Let us know more about your training details, please speak to your coach if you're unfamiliar on how to fill it up.
Please select which School/Dojo you're signing up for.
Training Dojo*

TPSITITEJuniorOther
Joined Date

MonthDayYear
Let me know when you joined/joining?
Do you have any additional background information we should know about?
Started Training (Year)
Keep it empty if you're new, for experience Karate-ka only to provide this information.
Current Grade/Dan
Keep it empty if you're new, for experience Karateka please provide this information.
Last Grading Date

DayMonthYear
Keep it empty if you're new, for experience Karateka please provide this information.
Other Martial Arts Experience
Let us know if you have other kind of martial arts experience.

Declaration

I, undersigned, release Singapore Hayashi-Ha Shitoryu Kai, and everyone connected with, directing, promoting, refereeing or judging in this event from all responsibilities due to accidents, loss, of life due to injury or accident that may occur during the entire event or as a direct or indirect result of this event. This release and consent must be signed by parent or guardian if the trainee/participant is under legal age of 21 years old.
Signature*

Clear
Signature of Parent/Guardian (if applicant is below 21 years old)

Clear
Your Age
Today's Date

MonthDayYear
Date
Should be Empty:

Membership Registration