Promotion to Tae Kwon Do - MartialArts4Fun

Student Name *

First

Last

Students Date of Birth *

Students Home Address *

Address Line 1

City

State / Province / Region

Postal Code

Mobile Contact Number *

Email Address *

Email

Confirm Email

Emergency Contact 1 - Name *

Emergency Contact 1 - Mobile Number *

Emergency Contact 2 - Name *

Emergency Contact 2 - Mobile Number *

Does the student suffer from any medical conditions that may affect their training? *

If Yes Please Give Details

Does the student suffer from any physical injuries or disabilities that may affect their training? *

If Yes Please Give Details

Has the student ever been convicted or cautioned of a criminal act? *

If Yes Please Give Details

Renewal Payment *

TAGB Declaration & Privacy Statement *

TAGB Privacy Policy *

BTC Insurance Details *

MartialArts4Fun Membership Fees & Attendance Policy *

Full Name of Person Submitting this form *