Licence Renewal Form

Step 1: Please complete the form in full and submit.
Step 2: Hand in Licence book and renewal fee together at next class.
Step 3: Ensure payment is made before licence book expiry date (Check inside first page of licence book).

First Name Surname Date of Birth

Address Post Code E-mail Mobile Number

Medical Condition
If you feel you have any medical condition that may affect your training, it is your responsibility to consult your doctor and you must inform your instructor BEFORE undertaking any exercise.

You must provide details below of any medical condition (eg - Asthma )

What is your/Child(s) current grade? 6 digit EKF Licence Number Expiry date of current licence

Please note if your current licence has expired you must renew using the Late Licence Payment option

Please select required licence

Declaration (Parent /Guardian to sign if applicant under 18 years)

1.) It is my responsibility to ensure that i have an up to date licence.
2.) I do not have any medical conditions that would prevent me from taking part in
strenuous exercise.
3.) I have never been convicted of a violent crime
4.) I accept that practising a Martial Art, may involve a risk of injury.
5.) I consent to the use of photography for promotional purposes (eg. JHKA & FKA websites)
6.) Should any classes stop running due to a pandemic or similar situation, you agree to continue your training using the online training platform which will be organised by Chief Instructor temporarily until normal classes resume.

Consent

Once form is submitted, licence book and payment must be handed in within 7 days from 08/04/2021

If your childs licence book and payment is handed in after the licence expiry date, this will be deemed a 'late licence' and the expired licence fee will be due.

Do you consent to the T&C above?

Consent