Pee-Wee Karate Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Welcome to our Pee-Wee karate club and family!

Please take a few minutes to complete our registration form below and we will be in touch in due course to confirm the space for you/your child in your chosen class.

Email *

Karate experience

Current student of karate club

New student

Trial*

Clear selection

Terms and Conditions for trial classes*

Please note that the general T&Cs below will only come into effect once your child has become a member of the club. The T&Cs will become void if a child does not continue after a trial session

Student First Name
*

Student Last Name
*

Student Date of Birth
*

YYYY

Dojo (karate class & venue)

Please choose a Pee-Wee Karate class from the drop down list.

School Year Group and Class Name of Child (at School):

(relevant only if karate is offered at the child's school)

Has the student, at any time, had any of the below?

Please select all the appropriate boxes or add any medical or physical problem which you think might interfere with his/her participation in karate training or that you feel relevant for us to know about.

Nut allergy

Arthritis or Bone/Joint Injuries

Other Injuries (please specify below)

Epilepsy

Asthma/Hay Fever

High Blood Pressure / Stroke

Hepatitis

Major Operations/Heart Problems/Murmur Muscle

Other or Special Needs (please specify below)

Parent or carer Full Name
*

Mobile Number
*

Phone Number

PO Address Line1 (building nr and street name)
*

PO Address Line2 (town/city)
*

PO Postal Code
*

Other contact

(add secondary email or EMERGENCY contact if different from aforementioned contact)

Student’s Declaration:
*

“I promise to uphold the spirit of Karate-Do, follow the Dojo Kun and never use the skills I am taught against any persons except in defense of family, friends or myself in the instance of extreme danger or unprovoked attack or in support of law and order. I have no health risk illness, other than stated previously, nor have I been advised by a doctor not to take physical exercise.” I (encase of minors, the parent/guardian) understand and abide by the Student’s Declaration.

Required

Terms and Conditions:
*

I agree to pay training term fees upon receipt of the invoice either from Pee-Wee Karate Ltd. or school my child attends (whichever may be relevant to the student). The student or guardian (in case of minors) must give ½ a school term written notice of intention to withdraw from karate classes. This written notice must be emailed to our office. The student is welcome to attend during the final notice period. Should the student/parent/guardian fail to provide written notice or wishes to stop karate immediately then ½ a term's fees over and above any outstanding fees at the time must be paid. I understand that whilst taking every reasonable precaution, instructors cannot be held responsible for injuries sustained to the student during karate training. I agree to let instructors know in advance should I have any objections to the club, parents/carers taking photographs and videos of students during Gradings and/or in class that might be used to advertise the club.

Required

Terms and GDPR Policy: Please read our GDPR privacy policy for information regarding the collection and processing of your personal data, available here.
*

I understand and accept the GDPR policy.

Required

Please add comments or questions here:

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Funakoshi Ltd. Report Abuse

Forms