RITA Registration

R.I.T.A. Annual Registration
Student Name*

First NameLast Name
Date of Birth*

DayMonthYear
Sex*

FemaleMale
Sorry, based on your date of birth, at {calculatedAgeRegistrationDate} you are too old to join the RITA.
Parent/Guardian*
Registration Calculation Date

DayMonthYear
Calculated Age on Registration Date
PreTeen Fee
PreTeen Processing Fee
Teenager Fee
Teenager Processing Fee
Adult Fee
Adult Processing Fee
Age Group Calculated Fee
Age Group Fee
Age
Age Group
WhatsAppName
RITA School*
Choose the RITA School you are registering with
RITA School
School Name
School Email
Email Recipient
Senior Instructor Name
Senior Instructor Email
School Code
Reg Year
This needs to be changed at the beginning of September each year to the new YY registration year.
RITA Number
Grade*
Phone1*

(required primary phone no.)
Phone2

(optional phone no. of secondary Parent/Guardian)
WhatsApp groups are used to communicate with students about events and notices. Please indicate whether or not you are happy to be added to a relevant group. Note that anyone can remove themself from the group at any stage, or request to be added to a group at any stage.
Include mobile in WhatsApp groups?*

OkayNo Thanks
Black Belt Email: From time to time the RITA would need to communicate with black belt students about events and notices. Please indicate whether or not you are happy to be added to a relevant email list. Note that anyone can request to be removed from the email list at any stage, or request to be added to the email list at any stage.
Black Belt Emails?*

OkayNo Thanks
Email*
(acknowledgement will be sent to provided email address)
ITF Database Consent

As a member of the ITF, do you give your permission to share part of the basic information from this form, like your name, date of birth, sex, grading history, photo ID, nationality, to be entered into the ITF Database Platform? This information will be required to have on your ITF record for interactions with the ITF, for any official ITF events, like seminars, courses, competitions and gradings. This information is entered into and maintained in the ITF Database by the RITA Data Protection Officer (DPO) on your behalf.
ITF Database Permission*

AcceptedDeclined

Previous Martial Arts Training

Only required if this is your first time registering with the RITA
Have you had any martial arts training before?

NoYes
System
Association
Instructor
Club
Grade Achieved

Marketing

Only required if this is your first time registering with the RITA
How did you find out about Taekwon-Do?
Date of commencement of training

DayMonthYear
Date

Health Statement

In relation to your ability to train in the physical activity of Taekwon-Do to the best of your knowledge do you...?
Had any injuries, diseases or illnesses?*

YesNo
(Injuries/diseases/illnesses) Please give details*
Any other physical defect, or physical weakness of any kind?*

YesNo
(Physical defect/weakness) Please give details*
Been refused any insurance, or had any special terms or conditions applied by any insurer?*

YesNo
(Insurance) Please give details*
Are you taking any medications at present?*

YesNo
(Medication) Please give details*

Payment

Payment Method*

Debit/Credit CardSEPA (Bank Transfer)Family Rate/Other
Family Rate/Other*
(Please add a note so that we fully understand this Registration)
IBAN
This is the IBAN number of the RITA account for the SEPA transfer
SEPA Payment
Please make this payment amount in the SEPA transfer
SEPA Receipt*

Attach an image of the SEPA (Bank Transfer) transaction
Cancelof
Card Payment

Registered
for admin purposes
RITA Forms Email
Have this field on this form so that it can be chosen in the options to be the From: address field in outgoing emails from Jotform
Sorry, based on your date of birth, at {calculatedAgeRegistrationDate} you are too old to join the RITA.
Should be Empty:

	Age	Fee	Note
Pre-Teens	5-12	€{preteenFee}
Teenagers	13-17	€{teenagerFee}
Adults	18+	€{adultFee}
Family Rate		€0	Family Rate: The third and subsequent member of a family (same household) is free Please register and pay for the first two OLDEST family members and select €0 family rate when registering all other YOUNGER family members
Other			If none of the above payment methods apply, choose Other, giving a description for the registration

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

R.I.T.A. Annual Registration

Previous Martial Arts Training

Marketing

Health Statement

Parental/Guardian Consent

Consent

Payment