MTC Ringwood Membership Application Form

MTC RINGWOOD

10 Maroondah Highway,
RingwoodVIC 3134

info@martialarts.com.au

www.martialarts.com.au

(03) 8806 9374
Membership Application Form

Thank you for joining MTC Ringwood!

MTC proudly promotes a culture of mutual respect and courtesy within a positive, inclusive, family-friendly atmosphere. It encourages all members to strive for excellence in their martial arts techniques and demands of them the highest standards of behaviour.
A condition of being part of MTC is to abide by our Codes of Respect, Ethics, and Conduct, our Privacy & Confidentiality statements and the cultural qualities promoted by our Mission Statement. Everyone associated with the club is an MTC ambassador. Whether training at the club or while interacting in your school, work, private life or through any form of social media (eg. Facebook, Twitter, Instagram, etc), ensure that every interaction with another person remains positive and non-judgemental.

We expect members to embrace those virtues practiced by the martial art community such as: Mutual Respect • Honour • Courtesy (politeness) • Integrity • Self-control

We nurture a culture of diversity and inclusivity that creates in its membership confidence, respect, self-esteem and self-worth. Martial arts teaches the importance of being responsible and honest to achieve harmony with society. An MTC student is the one who knows how to behave anywhere, anytime. All Codes of Respect, Ethics and Conduct, and our Privacy & Confidentiality and Mission Statements are available at: www.martialarts.com.au
Select the term you are applying for*
Application Date*

DayMonthYear
Date
Member Information

For the person attending classes.
Full Name*

First NameLast Name
Preferred Name/Nickname
Date of Birth*

DayMonthYear
Date
Gender*

MaleFemaleOther
Address*

Street Address

Street Address Line 2

CityState

Postcode
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
How do you prefer to be contacted?*

Phone and SMSEmailPhone & Email
Emergency contact name and number (if different from parent/guardian)*
Membership Age Level*

Musketeer (4-7yrs)Junior (8-13yrs)Senior (13yrs+ and adults)
Styles Attending*

TaekwondoBoxing/KickboxingWeapons/Stick FightingBrazilian Jiu-Jitsu
Parent/Guardian Information for under 18 year olds
Parent/Guardian Full Name

First NameLast Name
Phone Number

Area CodePhone Number
E-mail
example@example.com
Classes:

Please select which classes you'll be attending in the current term. You will be assigned to your selected classes for the term. This cannot be changed without contacting the MTC Team first. Any missed classes throughout the term may be made-up anytime during that term. Students or parents/guardians must notify reception and instructor/s when attending make-up class before class begins. This information goes to the attendance requirement for your grading.
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
SATURDAY
Membership and Term Fees

Annual membership is compulsory for all students. It includes membership, insurance, association, affiliations, and administration fees. Term fees are determined by the amount of classes you attend and by age group. Grading fees are part of the term fees however are only charged towards the end of the term if students are eligible and able to grade.
Annual Membership Fee: (includes insurance, affiliations and administration fees)*
Membership Package: (based on number of classes per term selected above)*
MUSKETEERS fees per term (select one)
JUNIORS fees per term (select one)
SENIORS fees per term (select one)
Grading Fee (due 1 week before term grading)
Family Discounts for multiple members (applicable to term fees only)*

Two members less 10%Three members less 20%Four+ members less 30%No Disc
Total Fees: (excluding term grading fee)
Pro-rata Fees (for staff use only):
Health Declaration

This form is to be completed in full by the applicant or by the parent/guardian if the applicant is under 18 years old. It is essential that all known details of pre-existing injuries, allergies or other medical conditions are declared on this form. The applicant supplies this information under the following conditions.

All information will be held in the strictest confidence. Student contact details will be used internally and will also be included on forms, sent to Australian Taekwondo for registration with the national governing body of Taekwondo in Australia (and other governing bodies as deemed necessary). Some information may be shared with the club’s insurance companies. Student contact details will not otherwise be shared with any third party organisations, without first contacting the student in question.

At the discretion of the Head Instructor, some medical information may be advised to other Instructors within the club. This will occur where it is deemed necessary that they be aware of conditions, allergies or injuries that might affect the students performance or limit their capacity to take part in certain activities, or which may be aggravated by certain exercises. Information on this form will also be shared with ambulance and/or medical personnel in the case of an accident or other medical emergency.
1. Are you taking prescribed medication which may impair reaction time or judgement?*

YesNo
If yes, give details:
2. Have you suffered any incapacity requiring medical attention in the past 12 months?*

YesNo
If yes, give details:
3. Do you have any pre-existing health conditions, or have any injuries/health concerns which may affect your training in martial arts?*

YesNo
If yes, give details:
4. Do you suffer from any known allergic reactions?*

YesNo
If yes, give details:
AGREEMENT TO MEMBERSHIP TERMS AND CONDITIONS

I, the undersigned, wish to apply for associate membership of Martial Arts Training Company (MTC) and Melbourne Taekwondo Centre. In doing so, I hereby agree to the following:
- I will abide by the rules and regulations of MTC. I will follow all directions given by the instructors.
- I will conduct myself in a proper manner at all times.
- I pledge that I will not apply the methods of martial arts outside of the club premises unless threatened with actual physical violence and then only when all other reasonable avenues of persuasion or escape are exhausted.
- I accept that many of the activities in which I will be participating in will be physical or of a martial nature, including but not limited to: hitting or kicking targets, sparring, self-defence and other exercises typically found in a martial arts club. In regards of this, I agree that MTC, it’s instructors and any member or fellow students, will not be held responsible for any injury sustained by the applicant whilst engaging in any club activity or exercise. I also indemnify the club, its instructors and members against any action in respect of such injuries sustained by the applicant.
- I acknowledge that it is my responsibility to be physically fit and capable to participate in all MTC activities. If not i will not participate in any class activity or event and will seek medical advice as needed prior to attending any class.
In signing below, I also declare that I have read and agree to the Medical report/Privacy Statement, Photography/Video Wavier, and Code of Respect printed here and on the overleaf.
Photography/Video Waiver

By signing this form I consent and agree that my child/ren and/or myself to be filmed, televised, photographed, identified and otherwise recorded during any MTC event. These recordings may be used for club purposes (MTC newsletter, website gallery, social media or otherwise displayed at MTC premises or promotions) and I additionally agree that any photos, videos or other recordings that I make during any such event shall be exclusively for private, non- commercial purposes unless I receive the express, written permission of MTC.
Consent to medical attention

I authorise the instructor in charge of training to consent, where it is impractical to communicate with me, to the child receiving such medical treatment as may be deemed necessary.
I have read, understood and accept the Terms and Conditions stated above:*

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Date
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Member Information

Parent/Guardian Information for under 18 year olds

Classes:

Membership and Term Fees