FREE MEMBERSHIP APPLICATION

1Contact Details

2Karate Details

Name*
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Email*
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Phone*
Date Of Birth*
Address*
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Current Dojo*
Who is your instructor?*
Dojo Information
Dojo*
Sensei Name*
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Sensei Email*
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Sensei Phone*
Grading*
Last Grading Date*
Do you have any physical disabilities or health problems?*
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- No
Describe all physical disabilities or health problems*
Additional Information
Membership Indemnity
I hereby apply to become a member of the Shorin-Ryu Karate Club, Nintai-Ryoku Dojo, with effect from accepting this electronic document. I agree that my membership with Nintai-Ryoku Dojo will be at the sole discretion of Nintai-Ryoku Dojo and might depend on whether my karate term club fees and annual affiliation fees with my current Shorin Ryu Karate Club are paid up to date. Should my membership fees and or annual affiliation fees with my current Shorin Ryu karate Club fall into arrears, my membership with Nintai-Ryuku Dojo might also be cancelled.

I also understand that any refund of any fees will be in the sole and unfettered discretion of the Shorin-Ryu Karate organization or the Sensei of the relevant Shorin-Ryu Club. I understand that karate is a contact sport subject to inherent risk of injury and I unconditionally accept such risks. I accept that although every endeavour will be made to ensure that I / my child do not suffer any physical injuries that I nor my child , my Estate or dependants will have any claim whatsoever against Nintai-Ryoku Dojo, its Sensei's, agents, employees, associates or other members for any injuries which I or my child may sustain as a result of my child's attending the club or participating in any activities or events undertaken under the auspices of the organization, regardless of whether same are caused through an omission or through any negligence on the part of the aforementioned persons. In this regard I hold harmless and indemnify Nintai-Ryoku Dojo and the organization and its employees, Sensei's and agents of any liability for any wrongdoing or damage / injuries caused through my / my child's participation or related activities.
Indemnity*
- I have read and agree with the terms and conditions of the Members Indemnity.
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FREE MEMBERSHIP APPLICATION

Dojo Information

Membership Indemnity