Kyokushin Dojo Membership form

Please complete form to enrol.

Please note that the equipment required for karate are the offical Karate shinpads and gloves which must be ordered on this enrolment form and will be included in your first invoice (select sizes in the section below). This applies to all karate students Grade 1's and above.

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

Member Name*

First NameLast Name

Training Dojo (School)*

Where are you in life?*

Working? Studying? Still at school?

Birth Date (ages 5+)*

DayMonthYear

Parent Name (if member is a minor)

First NameLast Name

E-mail for INVOICES

example@example.com

E-mail for communication (if different from invoicing)*

All communication (e.g. Class schedules, term dates, grading dates and general communication) are sent via our admin only Whatsapp business account. Please ensure that the number below is the number you wish to receive these messages on (we keep traffic to a minimum). Primary Mobile Number:*

Mobile number

Secondary number if required.

Mobile number

Student Photo - JPEG

Browse Files

HEAD AND SHOULDERS, PLEASE!

Grade 1 and older are required to have regulation karate shin pads.*

Grade 1 and older are required to have regulation karate gloves.*

Karate Suit Order - Suits will not be ordered until they are paid for. Our suits are imported and there is a lead time of up to 5 weeks or more as we can only order in batches.*

Please note that the cm indicator on the sizes is the height of the student from toe to head e.g. 0000 suit fits a student who is up to 100 cm tall. If you are not sure please ask your instructor.

My Products

Tote bag50.00ZAR

Tote bag for Pads and Gloves, mesh sides help keep them ventilated and fresh.

Quantity

Total 0.00ZAR

Any medical history or conditions that could affect your ability to participate in contact sports? *

NoYes (Please enter details)

Medical Conditions

Where did you hear about us?

Payment is due in the first 2 weeks of term (first 2 weeks of the quarter for adults).

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 term / 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. 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

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.

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.
Recognize and understand that such risk may be due to not only my own actions, but also the action, inaction or negligence of others.
Recognize that there may be other risks that are not known to me or to others or not reasonably foreseeable at this time.
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.
Assume all of the foregoing risks and accept personal responsibility for any damages that may result from injury, permanent disability or death.
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.
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.
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.
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*

Signature of Member or Legal Guardian