Please select which club/dojo you are joining.
This is for the contact details of students 18 years and older - or the primary contact for a student under 18 years of age.
If the student is over 14-17 years of age and has a phone number and email, and the student's parent/guardians permit him/her to be contacted directly, then put these in this section with the parent/guardian details in the next sections.
Do any of the above applicants suffer, or have ever suffered, from any medical condition or injury, or be on any medication that may affect their ability to train? e.g. asthma, high blood pressure, insulin-dependent diabetes, previous knee or back injuries etc...
NB: should any of the information specified in relation to injury or illness listed here change, the onus is on the student to inform theinstructor as soon as they become aware of this, and prior to taking part in any further training sessions.
Please check below to see that all details are correct. If you need to change anything, click the back-button, so that you can change them, then check again.
If everything is correct, then please sign at the bottom and submit it.
By signing below, I agree to act responsibly with the techniques taught to me by Kuro Obi Martial Arts (KOMA) and in line with the International Federation of Karate Australia Inc. (IFK Australia) Student Manual and Syllabus, and as may be changed and updated from time to time. Under no circumstances shall the information and techniques learned at KOMA be used outside scheduled karate training time(s), unless necessary for self-defence and/or during events sanctioned or organised by the KOMA or IFK AUSTRALIA.
I also agree to abide by the Terms and Conditions of the School (see link below), but in particular the following:
For a complete set of Terms conditions, click here. Note: this link should open in a smaller window/tab on your computer but as a whole new window on your mobile device. To come back to the form, just press BACK on your mobile browser.