Tae Kwon Do Membership Application

This form must be completed in full – one form per student.

Once completed, the form will be sent to your TAGB School Instructor.

You will then be emailed by return, to the email address you have provided in this application, further details regarding the completion of your membership.

Students Name *

First

Last

Students Home Address *

Address Line 1

City

State / Province / Region

Postal Code

Email *

Email

Confirm Email

Students Date of Birth *

Students height in cm *

Mobile Contact Number *

Emergency Contact Number 1 *

Name and relationship to the above named student *

Emergency Contact Number 2 *

Name and relationship to the above named student *

Do you suffer from any medical conditions that may affect your training? *

• Yes
• No

If Yes To Above Question, Please Give Details

Do you suffer from any physical injuries or disabilities that may affect your training? *

• Yes
• No

If Yes To Above Question, Please Give Details

Have every been convicted or cautioned of a criminal act? *

• Yes
• No

If Yes To Above Question, Please Give Details

Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming physically active. The questions below will indicate if you should check with our doctor before you start. If you are over 69 years of age and you are not used to being very active, you should check with your doctor. Common sense is your best guide when you answer these questions. Please read the questions below carefully and answer each one honestly: *I am happy to proceed with my membershipI will Check with my Doctor

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor? *

• Yes
• No

Do you feel pain in your chest when you do physical activity? *

• Yes
• No

In the past month, have you had chest pain when you were not doing physical activity? *

• Yes
• No

Do you lose your balance because of dizziness or do you ever lose consciousness? *

• Yes
• No

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition? *

• Yes
• No

Do you know of any other reason why you should not do physical activity? *

• Yes
• No

Please detail below any important information that our instructors should be aware of (This includes any medical or learning difficulties)

Photography - From time to time we take photographs & videos during our T.A.G.B. Tae Kwon-Do activities. We would like your permission to use these photographs & videos in our marketing. We will never reference you/your child by full name or provide any specific information regarding you/your child. We will use them exclusively for TAGB Tae Kwon-Do marketing. *I give you permission to use photographs of my child on in your TAGB Tae Kwon-Do marketing.Please do NOT take or use any photographs of my child.

TAGB Declaration & Privacy Statement *

• I have read the TAGB Declaration & Privacy Statement

TAGB Privacy Policy *

• I have read the TAGB Privacy Policy

BTC Insurance & Child Protection Policy Statement *

• I have read the BTC Insurance & Child Protection Policy Statement

MartialArts4Fun Membership Fees & Attendance Policy *

• I have read the MartialArts4Fun Membership Fees & Attendance Policy

Name of Person Submitting this form *

MartialArts4Fun Tae Kwon Do Membership *

Price: £50.00

Total *

£0.00

Stripe Credit Card *

Submit