Combat Academy UK Annual Membership Form

Combat Academy UK

Annual Membership Renewal. Details of person attending classes please.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

Town County

Postcode
Date of birth*

DayMonthYear
Phone Number
Email address (for newsletter and correspondence)
Are you a new member or a renewal?*

I am a new member applying for the first time.I am renewing my annual membership.
Club*
Date of expiry of current club licence (On back page, your licence will be dated one year from this date by your club instructor only) If you are a new member put todays date*

DayMonthYear
Date
Which Class do you attend?*
Grade (if any)
Payment *
prevnext( X )
Adult Annual Membership Fee (13 years and over)
£54.50

Junior Annual Membership Fee (12 years and under)
£49.50

Total

£0.00
Details of any medical information
i.e recent operations, serious illness more serious injury. Please note that you may be required to provide letter of approval from your doctor or medical specialist.
C.M.A.A. MEMBERS ARE AUTOMATICALLY COVERED BY GROUP MEMBER TO MEMBER AND PUBLIC LIABILITY INSURANCE PROVIDED YOUR LICENCE IS IN DATE. This is not a Personal Injury Policy. It provides cover in the event that you should damage property or injure another student during training. It will not pay benefits should you be off work for a length of time as a result of an injury sustained during training. For further information contact the C. M. A. A - www.cmaauk.com I the trainee indemnify the club in respect of any injury caused to another member or against losses caused to the club by any act of mine or default. I the trainee understand that the training and practice of the martial arts can be dangerous and I agree personally to bear all losses caused by injury whilst engaged in it. NOTE: You are reminded of the C.M.A.A bylaws, which state that the annual renewal of the licence is your responsibility and that out of date applications will be backdated. I agree whilst I am a member of the above named club within the Cobra Martial Arts Association that this form will be signed every year and will be acceptable for further licensing applications, which will be shown in my licence book. I also understand that if I allow my licence to remain out of date for any significant time, I will not be permitted to grade. Please note that your club licence will be renewed for 1 year from its current date of expiry and NOT from the date of renewal.*

Clear
Parent if under 18 years old.
Date*

DayMonthYear
Date

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

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