MTG Membership Registration Form

Fighting Fit Gym cc t/a MTG (Magua Taekwon-Do Group) Central

MTG Membership Registration Form
MTG Club *
MTG Class *
Name (of Member) *

First Name Last Name
Photo of Member

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Cancel of
Date of Birth *

Day Month Year
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ID #/ Passport #
Email *
example@example.com
Cell Number *

Area Code Phone Number

Address *

Line 1
Line 2
Suburb	Province
Postal Code	Country

Payment Method *
Medical Conditions
in case of Emergency
Emergency Contact Person *
Emergency Cell *
Your Relationship *
Medical Aid Company (NB if have)
Medical Aid Number
How did you hear about us? *
if other, please specify *
Indemnity

Consent of Risk:

I understand even though great care is taken, there may be a risk in the learning and practice of Taekwon-Do/Cardio Fighting Fit Kickboxing by which there is a possibility of serious injury or even death, as in most sports & physical activities. I agree as a condition of membership not to hold the venue, Fighting Fit Gym cc t/a MTG Fighting Fit Central, MTG Taekwon-Do Clubs, Taekwon-Do South Africa, Instructors, Members, Employees or visiting practitioners liable for any injury or loss whatsoever. I have further undergone a medical examination and was declared fit and well by a qualified medical practitioner for receiving training in the Martial Arts/ Cardio Fighting Fit Kickboxing. I am aware of the rules and regulations of the club where I will be receiving martial arts training and agree to abide by them.

I also understand the payment policy of the club as explained in the information sheet under important notes.
Registration Date *

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