Martial Arts Course Registration Form

Martial artist Information

Martial artist Name*

First NameMiddle NameLast Name

Adress*

Street and number

CityState/Region

Zip code

Mobile Number*

Phone Number

Birth date*

DayMonthYear

Gender

MaleFemaleOther

Current level

No experienceColoured beltBlack beltOther

Fiscal Code*

Parent/Guardian Information (if martial artist is under 18)

Name

First NameLast Name

Mobile Number

Phone Number

E-mail*

Emergency Contact's Name*

First NameLast Name

Mobile Number*

eg 021Phone Number

Does the martial artist have asthma, allergies, or any other medical condition? If yes, please describe.*

Budojutsu 90 min.

Ninjutsu group lesson Silver subscription (5 lessons stamp card) € 60,00Ninjutsu group lesson Gold subscription (11 lessons stamp card) € 120,00

Kamaejutsu 60 min.

Kamaejutsu group lesson Silver subscription ( 5 lessons stamp card)€ 40,00Kamaejutsu group lesson Gold subscription (11 lessons stamp card)€ 80,00

Junior Ninja Training 60 min.

Ninja Talons group lesson Silver subscription ( 5 lessons stamp card) € 40,00Ninja Talons group lesson Gold subscription (11 lessons stamp card)€ 80,00

Godai Meiso (meditation) 60 min.

Godai Meiso group lesson Silver subscription (5 lessons stamp card)€ 40,00Godai Meiso group lesson Gold subscription (11 lessons stamp card)€ 80,00

Private training Single 90 min.

Private lesson 90 min.: € 50,00

Godai Meiso (Meditation) 90 min. Private lesson

Earth (Chi) Meditation introduction € 50,00Water (Sui) Meditation introduction € 60,00Fire (Ka) Meditation introduction € 70,00Wind (Fu) Meditation introduction € 80,00Void (Ku) Meditation introduction € 90,00

Payment option

Cash - please make payment at beginning of a new period before classATM - please make payment at the beginning of a new period, before class.

New member requirements:

New Junior members need to wear a black uniform with a ranking rope (more info at the Teacher)
New members can wear their own sports pants and need to buy a Dojo
T-shirt (€ 15);
New Budojutsu and Kamaejutsu students need to purchase a ranking cord (€ 5,00) when they sign up for a membership;
New Budojutsu students need to buy their personalized Tessen (30 cm. stick € 5,00) when they sign up for a membership;
Budojutsu and Kamaejutsu students need to purchase their personalized wooden training sword (Bokken) in their first 3 months of training;
All new students, who take a Gold subscription, will receive one complementary Dojo T-shirt (to wear during classes)

* A Free T-shirt is given when a students signed up for a Gold subscription to Budojutsu or Kamaejutsu for the first time.

Acknowledgement I understand that martial arts carry a risk of injury and that the Eagle Spirit Budojutsu Dojo is not responsible for injuries or loss suffered as the result of participating in these activities. From time to time the Eagle Spirit Budojutsu Dojo will post photographs of our martial artists, coaches, and supporters online. We kindly hereby ask your permission to publish student pictures, please let us know if you want your picture removed if you decide to no longer agree of publication. We ask you to allow us 48 hours to cancel the publication. Be aware that we cannot remove pictures that are re-distributed without our or your consent (ie stolen from our website or socials).

Eagle Spirit Budojutsu Dojo will give 30 days written notice of any fee increase.

I herewith declare to have read and agree with the Dojo Etiquettes and the Terms & Conditions published on the website of The Eagle Spirit Budojutsu Dojo.

I herewith declare to have filled out this form in honesty, volunteerly and with a clear mind.

Medical Authorization In the event of an injury or medical emergency, I allow The Eagle Spirit Budojutsu Dojo to provide first aid, arrange transport to a medical facility, and authorise emergency treatment as recommended by a doctor for the martial artist named above. I understand that all reasonable efforts will be made to contact the martial artist’s parent and/or emergency contact if an injury or medical emergency occurs.

Signature*

Eagle Spirit Budojutsu Dojo Member Registration