NCC Kindergarten Registration Form

Welcome to Karate Community. We are excited to share this powerful synthesis of personal development and self defence. Ensure you fill out all of the details below to complete your membership registration.

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

Terms and Conditions

If you have any questions, please contact us.

All your information is protected by the Privacy Act 1988. View our privacy policy, or contact us for a pdf copy.

Participant's details

Participant's Name

First Name

Last Name

Date of birth

Gender

for our data collections only

female

male

rather not say

Email

Contact 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 "yes", please specify

Parent, guardian, emergency contact details

Name

First Name

Last Name

Phone number

If different from above

Relationship to participant

Terms and Conditions

Acknowledgement of use of image

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

yes

no

I have read and understood the Terms and Conditions for membership

Acknowledgement