PROGRAM APPLICATION FORM
Applicant Details
First Name
Your answer
Surname
Your answer
Date of Birth
MM
/
DD
/
YYYY
Address
House/Apartment Number and Street Name
Your answer
Suburb
Your answer
Postcode
Your answer
Mobile Phone Number
Your answer
Home Telephone Number
Your answer
Current Email Address
Your answer
Height (centimetres please)
For taekwondo uniform sizing
Your answer
Weight (kilograms please)
For taekwondo uniform sizing
Your answer
Applicant Parent/Guardian Contact Details
Parent/Guardian First Name
Your answer
Parent/Guardian Surname
Your answer
Emergency Details
If different from Parent/Guardian Details
Emergency Contact Name
Your answer
Emergency Contact Number
Your answer
ILLNESS OR DISABILITY
Existing illness or disability may affect your ability to participate in United Taekwondo training, activity and/or event.
Do you have an existing illness or disability that may affect your ability to participate in United Taekwondo training, activity and/or event.
If 'Yes', please give details
Your answer
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