Family Martial Arts Centres

General Information Form

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Family Martial Arts Centres

General Information

Date

Centre How did you hear about our school?

Students

How many students?

Contact details

Contact person Phone Mobile Address Postcode Email

Health and goals

Medical concerns What specifically would you like to achieve from martial arts training? Previous martial arts experience Other exercise or activity If a child, academic performance

Do you have the support of your partner, parents or others to get started today?

Yes No

Acknowledgement

In consideration for my attendance and participation in the martial arts training offered by Family Martial Arts Centres, I, the student/parent, acknowledge the existence of certain inherent risks in this type of training and hereby agree to assume all risks.

I further relieve the school, its management, assigned staff and fellow students from any liability resulting from loss, whether personal belongings or bodily injury.

I also hereby state that myself or my child is physically fit to take the prescribed course of instruction and do so of my own free will in exchange for an agreed upon fee. I understand there is no refund policy on any monies I will pay Family Martial Arts Centres.

Signature name Signature date

Signature

Instructor section

Instructor notes