Cape Town Dojo Membership Form

Cape Town Dojo Membership Registration
Please fill in this from to apply for membership.

You will be invoiced for the relevant fees once this form has been processed.
Member Name *

First Name Last Name
Birth Date (ages 5+) *

Day Month Year
Where are you in life? *
Working? Studying? Still at school?
Training Dojo (School) *
Parent Name (if member is a minor)

First Name Last Name
E-mail for newsletters and communication *
E-mail for INVOICES (If different to previous email)
example@example.com
Primary Mobile Number: *
Mobile number
Mobile Number for INVOICING (If different to Primary Mobile Number):
Mobile number
Student Photo - JPEG *
HEAD AND SHOULDERS, PLEASE!
Karate Suit Order *
Sizes are a guide only. Your instructor might recommend a different size and you will be billed accordingly.
Any medical history or conditions that could affect your ability to participate in contact sports? *

No Yes (Please enter details)
Medical Conditions
Where did you hear about us?

A Friend or colleague Online Search Our Website Social Media
Payment Policy
I understand that i can pay Cape Town Dojo per month or per quarter. Cape Town Dojo requires at least 1 month's notice to cancel my membership.

I understand that my first two classes are FREE with no obligation, and therafter my first month / quarter's fees are payable.

I understand that Cape Town Dojo relies on the prompt club dues payments of members to stay open. A quarterly invoice will be sent to me by email. I agree to pay my club dues as soon as possible, either by EFT or Cash. If I am unable to make a payment, I will notify the Dojo and make an arrangement.

I understand that any dogi, belt, or equipment fee is payable in advance.
Payment Understanding *

I have read and understand the payment policy
Privacy Policy
Image Rights *

I understand that occasionally, photos and videos from competitions and practices will be used in promotional material for the dojo. I agree to allow my image or my child's image to be used for this purpose and that I will not be compensated. I also understand that once a promotional item has been produced, it is not possible to remove my image or my child's image from the production.
Privacy Rights *

I understand that the dojo will never share my contact information for commercial purposes. I may, however, be contacted by the dojo managers about dojo announcements and information relevant to dojo membership.
Disclaimer and Waiver of Liability
1. Recognize and understand that martial arts training is a physical contact activity and that my participation might result in serious injury, including permanent disability or death, and severe social and economic loss.
2. Recognize and understand that such risk may be due to not only my own actions, but also the action, inaction or negligence of others.
3. Recognize that there may be other risks that are not known to me or to others or not reasonably foreseeable at this time.
4. Agree to inspect the facilities, equipment and pairings prior to participation. I will immediately inform an instructor if I believe that anything is unsafe or beyond my capability and refuse to participate.
5. Assume all of the foregoing risks and accept personal responsibility for any damages that may result from injury, permanent disability or death.
6. Enter martial arts training and/or competition entirely of my own free will and understand the importance of following the rules of training and competition.
7. I certify that I am in good physical condition, and have no disease, injury or other condition that would impair my performance or physical and mental well-being during training practice and/or competition. If I have any injuries or illnesses that could affect my ability to participate, I will notify the dojo managers and coaches, and discuss the appropriateness of martial arts training with my or my child's doctor.
8. Grant permission in case of injury to have a doctor, nurse, athletic training or other emergency medical personnel provide me with medical assistance or treatment for such injury.
9. Release, waive, discharge and covenant not to sue, Cape Town Dojo, its affiliated organizations and governing bodies, their officers, instructors and personnel, other members of the organizations, participants, supervisors, coaches, sponsoring organizations or their agents, and if applicable, owners and leasers of the premises from any and all liability to the undersigned, his or her heirs and next of kin for any and all claims, demands, losses and damages which may be sustained and suffered on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the realeasees or otherwise.
Disclaimer *

I have read, understood, and accept the disclaimer and liability waiver and sign it of my own free will
Signature of Member or Legal Guardian *

Clear
Signature of Member or Legal Guardian
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Cape Town Dojo Membership Registration

Payment Policy

Privacy Policy

Disclaimer and Waiver of Liability

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