AIKIJUJUTSU KOBUKAI AUSTRALIA INC. Membership Application & Training Agreement (Jotform)

Member Details

Please provide your personal details to become a club member.
Full Name*
Age ( in years Today)*
Email*
example@example.com
Mobile Phone*
Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact
Emergency Contact Name*
Emergency Contact Phone*
Emergency Contact Relationship*
Medical & Safety Information

Please provide any medical conditions, injuries, allergies, mobility limitations, medications, or other information relevant to safe training.
Medical & Safety Information*
Do you have any restrictions to your training that instructors need to be aware of?*
Membership Type

Select your membership type and options.
Foundation Course $39Trial Class10-Class PackFull Member (unlimited classes)
Adult 10-Class Pack — $180Student 10-Class Pack — $130
Paid Monthly in advance — $100 per monthOther
I understand this fee is include training fees for Standard Club Membership
Training Days

This is only a guide. Plan to arrive 15mins before the scheduled class start time.
Monday 7:30pm – 9pmWednesday 7:30pm – 9pmSaturday 1:15pm – 3pmDepending upon Shift/Roster
Code of Conduct & Dojo Etiquette

Our Code of Conduct helps create a safe, respectful and positive training environment for every student..
All members agree to:
- Train safely and respectfully
- Follow instructor guidance
- Maintain good hygiene and behaviour
- Support a positive, inclusive dojo culture
- Respect the lineage, curriculum, and teaching structure
I agree to follow the Code of Conduct and dojo etiquette.
Liability & Risk Acknowledgement

Martial arts is a physical contact activity. This means there is a small chance of bumps, strains, or accidental injuries. Our instructors take care to create a safe, supportive environment and teach students how to train responsibly. This acknowledgement simply confirms that you understand these normal, everyday risks and you agree to follow instructor guidance to help keep yourself and others safe. It does not remove your rights or waive any protections under Australian law..
I understand martial arts involves physical activity and inherent riskI agree to train within my ability and follow instructor guidanceI understand the Association is not liable for injuries caused by unsafe behaviour or failure to follow instruction
Consent

Please select the Social media consent and agreement to our terms and conditions.
Full Consent — photos/video may be used for website/social mediaInternal Only — teaching and private groupsNo Media
Member Signature*
Date Signed*

DayMonthYear
Date
Parent/Guardian Consent

This is required if the member is below age 18.
Full Consent — photos/video may be used for website/social mediaInternal Only — teaching and private groupsNo Media
Parent/Guardian Name
Parent/Guardian Mobile Phone
Parent/Guardian Email
example@example.com
Parent/Guardian Signature
Should be Empty:

Member Details

Emergency Contact

Medical & Safety Information

Membership Type

Training Days

Code of Conduct & Dojo Etiquette

Liability & Risk Acknowledgement

Consent

Parent/Guardian Consent