Licence Application Form - Step 1 (of 2)
Step 1 of 3: Submit
Please complete the form in full.
What is a karate licence?
Your child's karate licence is their martial artist insurance and is valid for one year.
Your child's karate licence is compulsory and all students are required to hold a karate licence in order to practice martial arts.
Your child's karate licence is also required to allow students to take part in gradings to progress to their next colour belt.
First Name
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Surname
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Date of Birth
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Address
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Post Code
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E-mail
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Mobile Number
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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 )
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Please select current grade
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Select an option:
18th Kyu - Beginner (White Belt)
Please select required licence
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Select an option:
Child Licence (£45.00 GBP)
Adult Licence (£49.00 GBP)
Please submit one official passport photo for the licence book
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Select an option:
I will submit one passport photo in class
Please select your dojo location or school club name?
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Select an option:
Woodpecker Hall Academy
Club Membership Terms & Conditions
Do you agree to all of the following membership rules?
It is your responsibility to renew your karate licence annually as all students must have a valid and up-to-date licence for karate
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Select an option:
I accept and will renew the licence annually
You accept that in addition to purchasing a karate licence, you will also be required to pay for lesson fees.
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You accept that our lesson fees are based on 5 weeks of lessons to be paid in advance per half term
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You accept that there are no refunds for any reason or non attendance
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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.
Do you consent to the T&C above?
Consent
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Select an option:
Yes I Agree to the T&C above
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