AUSTRALIAN GOJU KAI KARATE

 

MEMBERSHIP APPLICATION

logo

NAME   AGE  
ADDRESS
    POSTCODE  
TELEPHONE  
EMAIL  

Any previous karate clubs you have belonged to

 


Member Fee

$30 p.a

Class Training
(Multiple Locations)

$10 per night, or $70 per Month, or
$380 per 6mths, or $700 per year + free Gi

DECLARATION

1. Whilst all care is taken by the Australian Goju-Kai Karate club, karate is a contact sport and a dangerous recreational activity and injuries, including but not limited to permanent disability, can occur. I fully understand that the Goju-Kai Karate club accepts no responsibilities for any injuries incurred, & agree to abide by all rules of the Australian Goju-Kai Karate club. I also agree to do what I am told when I am told & how I am told.

2. I, the undersigned in consideration, & a condition of acceptance of my entry of the above school for myself, my heirs, executors & administrators, hereby waive all & any claims, right of cause or action which I or they might otherwise have, arisen out of any life or injury, damage or loss of any description whatsoever which I may sustain in the course of or consequent upon my entry or partition in the said school.

3. I agree to allow photographs or images of myself/my child to be placed on the Goju-Kai Karate Club website and to otherwise be used for promotional or instructive purposes.

4. This waiver, release & discharge shall be & operates in favour of all persons, corporations & bodies involved or otherwise engaged in promoting or staging the event & the servants, agents, representatives & officers of any of them.

BY SIGNING THIS FORM I HAVE READ, UNDERSTOOD & AGREE TO ALL OF THE ABOVE

Signature of Applicant   Date  
Signature of Parent or Guardian for applicants under 18 years old   Date  

 

How did you find us ? (Please tick all categories that apply.)

 
Recommended by friend
 
White Pages
 
Yellow Pages
 
Big Colour Pages
 
Pin Up Poster
 
Letter Box Leaflet
 

Internet Web Site

 

Internet Search

 
Other (please provide details) :