Registration Form
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Email *
Karate Waikato - JKA Waikato
Members Name *
Parent/Guardian (if over 18 please use N/A) *
Address *
Contact Phone
Mobile *
Date of Birth *
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Height (in centimetres- cm) *
Weight (in kilograms- kg ) *
Medical Conditions *
How did you hear about the club? *
Date of Joining *
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DECLARATION the undersigned, my heirs, executors and administrators, hereby waive all my claims, which I or they may otherwise have, arising out of any loss or life, injury loss of any description whatsoever, which I may sustain or suffer in the course of or as a consequence the said karate training. This waiver release and discharge shall be in favour of all persons, joint or severally involved in staging or promoting the said karate training. *
Required
Release of Liability. As the legal parent or guardian, I release and hold harmless Karate Waikato, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of Karate Waikato, its owners and operators or travelling to or from studio premises. Students are to be dropped off to, and collected from, the inside of the premises. *
Required
Billing & Payment information. I am aware that Karate Waikato will give me an invoice 3-5 weeks prior to the start of the upcoming term. If I wish to re-enrol into the upcoming term, no action is required after my initial enrolment. Priority placement is held. However, I understand that my placement is only held if my account is paid by the due date. Fees are due and to be paid on a pre-paid basis unless prior arrangements have been made. Fees that have not been paid in the first two weeks of term will incur a $20 late admin fee. Cancellation within two weeks of commencement date incurs a booking fee of $40. Payment can be made by direct bank transfer (acc details on invoices). Any cheque, cash payments need to be taken to the instructor during training nights, please. *
Required
Refunds/Cancellations. I am aware that there are no refunds ONCE CLASSES HAVE BEGUN unless due to medical reasons(and with a medical certificate). I understand that Karate Waikato will not issue refunds for missed classes nor early withdrawal during a term. *
Required
Uniform. I am aware that uniform is compulsory for all students. New students to the club are required to have the uniform after one term of training. Uniform pricing can be viewed on the website www.zenjo.co.nz. *
Required
Photographic Release. I agree that my child's picture or likeness can be represented and published in any Karate Waikatopublication or Media. *
Required
Medical Emergency. I give permission to Karate Waikato and its owner/staff to seek medical treatment for the student listed above in the event they are not able to reach a parent or guardian. In the fields above, I have declared any physical/mental problems, restrictions, or condition and/or declare the participant to be in good physical and mental health. I've read the above and agree. *
Required
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