Islington Martial Arts Registration Form

Student Name

First NameMiddle NameLast Name

Birth Date

MonthDayYear

Gender

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student E-mail

example@example.com

Mobile Number

Phone Number

Work Number

Company

Why do you want you/your child to study Choi Kwang Do?

Select multiple answers

How did you learn about this school?

Select multiple answers

Why did you choose this school?

Select multiple answers

Please select the location you're enrolling to

IslingtonWatford

Have you had any previous Martial Arts Experience? If 'Yes' which style, how long and Grade reached

Do you suffer from any medical conditions?

Please provide any additional details about medical history

MEMBERSHIP PRIVILEGES

Membership Licence PRIVILEGES: Each member will be provided with an official Choi Kwang-Do membership licence number upon enrolment. The licence number must be presented when visiting other Choi Kwang-Do Schools. Transfer PRIVILEGES: If any member must transfer out of the local area, the remainder of their membership will be honoured at any Choi Kwang-Do Affiliate School. Members may transfer within the local area by consent of the Chief Instructor in accordance with the rules and regulations of Choi Kwang Do Martial Art International. Special Events PRIVILEGES: All current membership licence holders are authorised to attend any promotional tests, seminars, etc., hosted by Choi Kwang-Do Martial Art International once all fees are paid.

I understand there may be a risk in learning & practicing the use Choi Kwang-Do by which it is possible to injure or kill. I have watched Choi Kwang-Do being taught and agree as a condition of membership not to hold any of its Schools, Instructors, or students liable for any injury I may sustain while practicing Choi Kwang-Do. I agree to obey the rules of Choi Kwang-Do and my Instructor. I agree not to misuse the knowledge gained through training in Choi Kwang-Do. I understand that the instructor has the right to withhold tuition if I violate the code and ethics of Choi Kwang-Do. Signing this form means acceptance of these rules & regulations.

Payment*

Membership enrolmentHarper CKD -Islington Martial Arts joining fee

£147.00 for each year

Total

£0.00

Signature

CHOI KWANG DO

STUDENT ELIGITBILITY QUESTIONNAIRE