Karate Holiday Camp Registration Form 6 July 8:30 - 15:00pm
6 of July 2026 (Development competitor / Non competing athletes/ Give it a go day).
Address - 45 Huntriss Road Karrinyup - 6018
Contact - Graz Prinsloo 0433871982
Email -
sensei@stirlingkarate.com.au
Website - www.stirlingkarate.com.au
Participants Details:
I am booking for:
*
Monday the 6th July (Development competitor / Non competing athletes/ Give it a go day)- $99.00
Full Name
*
First Name
Last Name
DOB
*
Age on 6 July 2026
*
Address
*
Street Address
Street Address Line 2
City
State
Postal / Zip Code
Skill Level
*
Please Select
Beginner
My child does karate
Competition karate level
Belt Level
*
Please Select
NA
White - Orange Belt
Green and above
Club
*
Please Select
Stirling
Gold Martial Arts
Shobukan
Other
Primary Contact Number
*
Format: (000) 000-0000.
Name of Contact Person
*
First Name
Last Name
Relationship
*
Other Emergency Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Name
*
First Name
Last Name
Relationship
*
How did you hear about us?
*
Please Select
WatsApp
FB
Insta
Friend
Other
Special requests or important information/medical conditions:
Friends are important - Please list if there is someone your child would like to group with:
Early drop off?
Yes
No
Maybe
Waiver and Indemnity
Date
*
-
Month
-
Day
Year
Date
I agree with the conditions above:
*
Agree
Agree with the following exclusions
Specify exclusions so we can discuss further:
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