SGS Taekwondo Registration Form

Name of Student *

First Name Last Name

SGS Class

e.g. J1G

Name of Parent/ Guardian *

First Name Last Name

Parent's / Guardian's Mobile Number *

Please enter a valid phone number.

I am most interested in:

Fitness Discipline Competition Self Defence Earning a Black Belt Other

Student's Gender *

Student's Date of Birth *

Date

Student's Weight

Pounds/ lbs

Student's Height

Feet.Inches e.g. 5.7

Skill Level

Beginner Intermediate Advanced

Parent's/ Guardian's Email *

Confirmation Email example@example.com

Home Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Emergency Contact's Name

First Name Last Name

Emergency Contact's Number *

Please enter an emergency contact number.

Medical History

Indicate any injuries, respiratory conditions, cardiac conditions or other conditions which may limit your child's participation in strenuous activity.

PARTICIPATION AGREEMENT

1. I understand that my child/ward is expected to observe the reasonable instructions of THE INSTRUCTOR/ COACH.

2. I understand that, even though there are non-contact aspects of training, Taekwondo is considered a contact Sport and there may be occasions where my child may be asked to engage in Sparring or situational self-defense drills or activity during Taekwondo training.

3. I hereby declare that my child/ward is fit to participate in this Taekwondo programme and agree to provide a declaration to that effect from a Medical Doctor if I am requested to do so by the INSTRUCTOR/COACH.

4. Any material non-disclosure will render this agreement voidable at the option of THE INSTRUCTOR/ COACH.

5. I understand that THE INSTRUCTOR/ COACH shall provide advice and structured Taekwondo classes for participants and will take all precautions to maximise the safety and well-being of participants. I accept that, despite this, there is a risk that my child/ward may be injured while participating in Taekwondo classes and hereby agree that the INSTRUCTOR/COACH shall not be liable therefor.

6. I agree that THE INSTRUCTOR/ COACH may suspend or revoke my child’s/ward’s participation in the after-school Taekwondo programme if he/she is engaged in aggressiveness, persistent bad language, any immoral act or other thing which may bring the programme into disrepute or consistently conducts him/her-self in any manner which constitutes a nuisance to other participants. No refund shall be given for any participant who is removed.

I have read and understand the participation agreement and agree to the terms. *

Yes

Signature

Clear

St. Gabriel's After-School TAEKWONDO with Instructor/ Coach Mr. Henderson Turton