IFK Australia Registration

This form is for students who are going to be joining any of the IFK Australia dojos

Dojo

Please select which club/dojo you are joining.

KKC Five Dock Westside Newtown Petersham

Student's Details

Name* Surname*

Date of Birth* Gender* M F Other

Address

Address* Suburb* Postcode* State

Contact Details

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.

Primary Phone* Primary Email*

Parent/Guardians

Parent/Guardian Phone Parent/Guardian Email

Parent/Guardian 2 Phone Parent/Guardian 2 Email

In case of Emergency

Emergency Contact Emergency Phone

Health Information

Reasons for doing karate

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.

Do you have any injuries or medical conditions? Yes No

Summary Page

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.

About the Student

Dojo

Name

Surname

Date of Birth

Gender

Address

Suburb

Postcode

State

Contact details

Primary Phone

Primary Email

Parent/Guardian 1 Phone

Parent/Guardian 1 Email

Parent/Guardian 2 Phone

Parent/Guardian 2 Email

Emergency Contact

Emergency Phone

Health Information

Reasons for doing karate

Do you have any Injuries or medical conditions?

Injury/Medical Details

Waiver and Signature

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:

The student represents that he or she is not suffering from any heart, lung or other bodily ailment and is in all respects physically fit to engage in the martial arts course.
The student has been advised that strict observance of the rules and regulations relative to martial arts self-defence training is mandated and also includes the use of protective equipment. The School does not warrant that the protective equipment will completely eliminate the possibility of accident or injury but will substantially reduce the risk of accident or injury.
Physical contact will be used by employees of the school, other students, and authorised individuals, as part of the course of instruction. Student has been advised of such fact and gives full consent to any physical contact as may be required or customary to martial arts training.
In recognition of the possibility of accident or injury connected with martial arts training, student waives any right or cause of action of any Kind arising as the result of such activity from which any liability may or could accrue to the school, its officers, agents, employees, or instructors.

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.

Signature

Making sure you're real!

This form is for students who are going to be joining any of the IFK Australia dojos

Summary Page

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