Personal Training Registration Form

Thanks for booking Personal Training. We are excited to share this powerful synthesis of personal development and self defence.

Please note, you must be over 18 to complete your Personal Training Registration.

Before submitting your form, please read our terms and conditions for training.

Terms and Conditions

If you have any questions, please contact us.

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Participant's details

Participant's Name

First Name

Last Name

Preferred pronouns

Date of birth

Email

Your invoice will be sent to this email. If under 18, email of Primary/Emergency Contact.

Contact phone number

If under 18, Primary/Emergency contact's phone number.

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Does the participant have any pre-existing medical conditions?

This information will help us provide the best experience and care for the participant.

No

Yes

If you answered YES, please specify

Primary/Emergency contact details

Name

Primary/emergency contact must be over 18.

First Name

Last Name

Phone number

If different from above

Relationship to participant

Terms and Conditions

Use of image

Do you give permission for photography to be taken of your child in class?

Yes

No

KC Newsletter

Do you want to sign up to receive our newsletter? There is good stuff in there, and we promise we won't Spam you!

Yes

No

T&C's

I have read, understood and agree to the Terms and Conditions for participation in Karate Community programs.

✓

Terms and Conditions