MMK Kata Seminar

Step 1 of 2: Submit

Please complete the below form for registration for the MMK Kata seminar. Please arrive at 11:30 for registration. The seminar will run from 12:00-16:00 Please ensure your bring fluids and food for a lunch break. Location: Blackwater Leisure Centre Park Drive Maldon CM9 5UR

Name of athlete in attendence * Contact number * Parent/Guardian * Email Address * Parent/Guardian Phone Number * Karate Club and kyu/dan grade * Date of Birth *

KATA SESSION 12:00-16:00 * SRKFE MEMBER (£30 GBP) NON SRKFE MEMBER (£40 GBP)

In the past month, have you had a chest pain when you were not doing physical activity? * Yes No

Have you ever felt a pain in your chest when you have been completing a physical activity? * Yes No

Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor? * Yes No

Is your doctor currently prescribing medication for your blood pressure or heart condition? * Yes No

Please make all payments to the following bank details

Use the athletes last name as reference:

ACC Name: Max Millard
Sort Code: 77-68-72
Account Number: 01958868

If you have any questions, please email at maxmillardkarate@gmail.com

I agree for any images and video to be used for Social media and/or advertising purposes * Yes No

I have my instructors permission to attend the seminar *

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