City Fitness Karate Club

Full Name *

Preferred Name

Date of Birth *

Nationality *

Gender *

Phone *

Email *

Residential Address

City / State

Guardian information is required for child/ward registrations. You confirm responsibility for accurate info, consent and emergency details.

Parent/Guardian Full Name *

Relationship *

Phone *

Email *

Address if different from member

I am responsible for providing accurate information, consent and emergency details for this member. I understand the club will contact me for all matters relating to safety and membership.

SECTION D — EMERGENCY CONTACT

Name *

Relationship *

Primary Phone *

Alternative Phone

SECTION E — MARTIAL ARTS EXPERIENCE

Have you previously trained in any martial art?

HEALTH & SAFETY

Any medical condition we should know about?

Recovering from injury or surgery?

TRAINING OBJECTIVES — tick all that apply

SECTION I — CLUB RULES (12)

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Members must bow upon entering and leaving the dojo and show respect to instructors and fellow students.
Clean, correct karate-gi must be worn; keep nails trimmed and remove jewellery.
Punctuality is required. If late, wait at dojo edge and seek permission to join.
Follow instructor directions at all times. Do not attempt techniques beyond your level without supervision.
No sparring or contact outside supervised class. Control is paramount.
Maintain hygiene and personal conduct befitting martial arts.
Fees must be paid by due date. Membership requires TTOSR affiliation.
Advise instructor of any injury or illness before training.
Children must be supervised before/after class; guardian pickup required for under 12.
Zero tolerance for bullying, discrimination or unsafe behaviour.
Dojo equipment must be cared for and returned.
Club may amend rules with notice; continued training constitutes acceptance.

I have read, understood and agree to abide by the Club Rules.

SECTION J — DOJO KUN

I acknowledge the Dojo Kun as the guiding principles of training.

SECTION K — PARTICIPATION, CONSENT & DECLARATION

I understand karate is a contact martial art involving physical exertion and risk of injury. I voluntarily participate at my own risk, agree to follow safety instructions, and declare health information is true and complete. I will advise of any changes. I agree to the Code of Conduct, including respect, discipline, non-violence outside dojo, and safeguarding of children. I understand misconduct may lead to suspension.

Media & Photography Consent

Privacy & Use of Information: I consent to City Fitness Karate Club & TTOSR collecting my data for membership, grading, insurance, safety and communication. Data is stored securely and not sold.

Member Name (Signature) *

Date

Registration

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Member

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Guardian

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Emergency

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Martial Arts

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Karate Detail

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Health

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Objectives

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Consents

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DECLARATION

By submitting, I declare all information is true and I agree to Club Rules, Dojo Kun, participation risks, media choice and privacy as marked. For child/ward, I sign as parent/guardian with authority to consent.

You will see a confirmation screen and reference number for club use. Re-submitting updates your existing club record — no duplicates.

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KARATE CLUB

Member / Student Information

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Member / Student Information

Who are you registering?

Registration Submitted

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KARATE CLUB