Membership & Waiver Form

Membership & Waiver Form

Complete your membership details and review the waiver terms before submitting.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Waiver and Release Agreement
Signature
Date

MonthDayYear
Date
Preferred Name
Pronouns

Self-describe
Date of Birth

MonthDayYear
Home Postcode
Occupation
How did you hear about Forged Hub?

Other
Preferred Contact Method
Best Times to Contact You
Health and safety
Allergies
Current injuries
Recent surgery
Long-term health conditions
Heart or circulation conditions
Breathing conditions
Epilepsy or seizures
Diabetes
High or low blood pressure
Fainting or loss of consciousness
Pregnancy
Medication that may affect participation
Mobility or accessibility needs
Mental-health support needs, optional
Any reasonable adjustments required
Whether their doctor has advised against intense exercise, sauna or cold-water exposure
Confirmation they will inform instructors if their health changes
Current medication you're taking
Current illness
Which activities do you do?
Previous martial-arts experience
Current grade or belt
Previous concussion
Head, neck, back, knee or shoulder injuries
Whether they own gloves, wraps, gumshield and protective equipment
Preferred contact level
Sparring consent
Confirmation that sparring is optional
Agreement to follow coach instructions
Agreement not to train while injured or unwell
Diets
Membership type
Membership start date

MonthDayYear
Date
Renewal date

MonthDayYear
Date
Preferred payment frequency
Discount or referral code
Low-income or hardship support request
Donation option
Gift Aid declaration, where appropriate
Agreement to membership rules
Swimming ability
Confidence in open water
Previous sea-dipping experience
Cold-water experience
Maximum previous immersion time
Whether they own suitable footwear, gloves or dry clothing
History of cold shock, panic or breathing difficulties
Whether they agree to follow instructor exit instructions
Confirmation they will not enter the water alone
Confirmation they will not attend under the influence of alcohol or drugs
Consent for emergency services to be contacted
Emergency contact address
Second emergency contact
Relationship to member
GP surgery name
Important emergency instructions
Preferred hospital
Consent for first aid
Consent for ambulance assistance
Consent for emergency contact notification
Should be Empty: