Sprint Martial Arts Registration
Please complete the form below to sign up
Member Name
*
First Name
Last Name
Birth Date (ages 5+)
*
Please select a year
2025
2024
2023
2022
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1920
Year
Please select a month
January
February
March
April
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June
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Month
Please select a day
1
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Day
Parent or Legal Guardian
First Name
Last Name
Phone Number:
*
-
Area Code
Phone Number
Emergency Contact
First Name
Last Name
Emergency Contact Phone Number
-
Area Code
Phone Number
E-mail (for club newsletters and invoicing)
*
Address:
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Post code
Location of enrolment
Surbiton
Walton
Sutton
Programme
Little Dragons
Junior Beginner
Junior Leadership
Adults Beginner
Adults Leadership
CIT
Price of Enrolment fee
*
Price of Tuition (If paid in full)
*
Price of monthly instalment
Term of tuition
*
6 months
1 years
3 years
Have you taken Martial Arts classes before?
Yes
No
What Style Did You Study
Judo
MMA
BJJ
Karate (any variant)
TKD
Other
What Martial Arts rank are you currently?
Please Select
Junior (under 16)
Rokyu
Gokyu
Yonkyu
Sankyu
Nikyu
Ikkyu
Shodan
Nidan
Sandan
Yodan or above
Do you have any medical history or conditions that could affect your ability to participate in contact sports?
*
No
Yes (Please enter details)
Medical Conditions
Do you confirm that you are physically capable of participating in martial arts, kickboxing, and combat sports, and that you have not been advised by a medical practitioner to refrain from such participation?
Yes
No
Are you a member of a recognised martial arts organisation ?
Yes
No
If so, please state which organisation
Where did you hear about us?
A Friend or colleague
Online Search (Google, Bing, Yahoo)
Instagram
Facebook
Other
Terms and conditions
You undersatnd payment policy
*
I have read and understand the payment policy
Membership Rules
MEMBERSHIP RULES
Never leave the mat or the dojo without receiving permission from the instructor.
No food, drink or chewing of gum are allowed on the mat.
No non-martial arts activity is to take place during class time. Show your instructor respect by paying attention. Save the conversation for after class.
Report all injuries to the instructor immediately. When arriving at class with an injury, the instructor must be notified prior to the start of class.
Shoes are NEVER to be worn on the mat.
Water bottles are permitted in designated area at mat-side. Water bottles are to have water or electrolyte beverages (like Gatorade) only.
Never come to class under the influence of drugs or alcohol.
Members are to keep their uniforms clean and in good repair.
Finger and toenails are to be kept clean and trimmed to a reasonable length to prevent injuries to training partners.
No jewelry may be worn during class unless specifically approved by the instructor.
Members without uniforms should not have anything in their pockets. Martial arts involves pulling on the clothing, and whatever you wear could become torn.
No practicing of martial arts skills or new techniques is allowed without permission of the instructor. This includes techniques you learned on the internet, saw during a competition, or on a video.
Spills are to be cleaned immediately. Trash should be placed in the proper container. Spectator chairs should be stacked at the end of class.
Bullying is not tolerated in or out of the dojo. Members using their Judo skills for bullying will not be allowed to return.
You agree to our rules
*
I have read, understood, and accepted the rules for membership.
Privacy Policy
Can we take photos and capture video footage for our social media, website, promotions and marketing.
I understand that occasionally, photos and videos from club competitions and practices will be used in promotional material for the club. I agree to allow my image or my child's image to be used for this purpose and that I will not be compensated. I also understand that once a promotional item has been produced, it is not possible to remove my image or my child's image from the production.
Contact permission
*
I understand that the club will never share my contact information for commercial purposes. I may, however, be contacted by the club managers about club announcements and information relevant to club membership.
Disclaimer and Waiver of Liability
Recognise and understand that martial arts training is a physical contact activity and that my participation might result in serious injury, including permanent disability or death, and severe social and economic loss.
Recognise and understand that such risk may be due to not only my own actions, but also the action, inaction or negligence of others.
recognise that there may be other risks that are not known to me or to others or not reasonably foreseeable at this time.
Agree to inspect the facilities, equipment and pairings prior to participation. I will immediately inform an instructor if I believe that anything is unsafe or beyond my capability and refuse to participate.
Assume all of the foregoing risks and accept personal responsibility for any damages that may result from injury, permanent disability or death.
Enter martial arts training and/or competition entirely of my own free will and understand the importance of following the rules of training and competition.
I certify that I am in good physical condition, and have no disease, injury or other condition that would impair my performance or physical and mental well-being during training practice and/or competition. If I have any injuries or illnesses that could affect my ability to participate, I will notify the club managers and coaches, and discuss the appropriateness of martial arts training with my or my child's doctor.
Grant permission in case of injury to have a doctor, nurse, athletic training or other emergency medical personnel provide me or my child with medical assistance or treatment for such injury. The cost of any treatment or hospitalization arising from injury during training or play shall not under any circumstance be paid by Sprint Martial Arts LLP, its affiliated organizations and governing bodies, their officers, instructors and personnel, other members of the organisations, participants, supervisors, coaches, sponsoring organizations or their agents.
Release, waive, discharge and covenant not to sue, Sprint Martial Arts LLP, its affiliated organisations and governing bodies, their officers, instructors and personnel, other members of the organisations, participants, supervisors, coaches, sponsoring organisations or their agents, and if applicable, owners and leasers of the premises from any and all liability to the undersigned, his or her heirs and next of kin for any and all claims, demands, losses and damages which may be sustained and suffered on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the realeasees or otherwise.
I undertand and accept the liabilty waver
*
I have read, understood, and accept the disclaimer and liability waiver and sign it of my own free will
Signature of Member or Legal Guardian
*
Date
*
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