Student Information
Name *
D.O.B. *
Please note DOB order for this form is Month - Day - Year
Parent Name (if under 18)
Parent Name (if under 18)
Contact Information
Please place a primary mobile contact number here with no spaces in-between numbers
Address *
Class Information
Please select the main class you are registered to train in.
If you plan to train more than once a week please select your secondary class below. A third choice can be added to the notes at the end of this form.
This is payable to your instructor and further information on what is included can be found in your welcome letter.
Please let us know how you plan to pay your lesson fee's. This is purely for record keeping purposes and allows us to provide you with the correct payment information. This can be changed at any time.
To be completed by the Applicant / Parent / Guardian I the undersigned understand that there may be some risk involved by studying Martial Arts and hereby release Warrior Martial Arts, all instructors and students from any and all liabilities for any type of injuries or loss sustained whilst training, studying, practicing or in the application of the Martial Arts. The undersigned also states that he/she is in good physical condition and knows of no reason why he/she cannot participate in Martial Arts. Finally, he/she states that they are giving their information to us willingly, with the understanding that it is solely for communication and record keeping purposes. WMA will never knowingly share your information with anyone. By my ticking of the boxes below and submission of this form, I acknowledge that I have read, understood and agreed to the above policies and procedures of joining and training with Warrior Martial Arts.
Declaration Confirmation *
Full Name of Person completing this form