PERSONAL DETAILS
This information is for communication, health and emergency purposes. It will be held by instructors only.
Full Name *
Email (We send out most club communication via email) *
Address and Postcode *
Mobile Phone Number *
Date of Birth (M,D,Y)
MM
/
DD
/
YYYY
How did you hear about us?
Health Questionnaire. Please select all that apply:
If you selected any of the above and wish to give further details please do so here. Please consult your doctor before increasing physical activity or beginning martial arts training.
EMERGENCY CONTACT DETAILS
Please provide details of two people we can contact in the event of an emergency.
Contact 1: Name, Mobile Telephone Number, Relationship to participant *
Contact 2: Name, Mobile Telephone Number, Relationship to participant *
Waiver
I understand and I am aware that martial arts training, sparring, conditioning, strength, flexibility and aerobic exercise, including the use of equipment, indoors or outdoors, is potentially hazardous. I also understand that exercise and martial arts activities involve a risk of injury and even death, and that I / my child, are voluntarily participating in these activities and using equipment and facilities with the knowledge of the dangers involved. I hereby agree to assume and accept all and any risks of injury or death.

I do hereby waive, release and discharge North East Martial Arts from any and all responsibility or liability for injuries or damages resulting from me / my child participating in martial arts and exercise, or me / my child's use of equipment or facilities in the above mentioned activities.

I acknowledge that I / my child are either physically well and know of no reason why I / they should not participate in martial arts training and associated exercise, or I / they have either had a physical examination and have been given my doctors permission to participate, or that I / they have decided to participate in activity and use equipment without the approval of a doctor and do hereby assume all responsibility for my / their participation.
I have read and understood the above consent-liability waiver. *
Required
Training fees
Training fees should be paid by monthly standing order. The monthly fee is based on a 46 week year, allowing for instructors to take six weeks off. Occasionally, when instructors are sick, have family emergencies or there are problems at a venue (double booking etc) classes may also be cancelled. We will endeavour to put on additional classes or move you to another class in this instance.
I understand training fees are based on a 46 week year. *
Required
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