Takapuna Dojo Registration Form

* Required fields to be filled in

Students name*

Parent/Guardian's name

Email address*

Mobile number*

Student's Date of Birth (mm/dd/yy)*

Gender
SelectMaleFemale

Confirm Class would you like to attend?*
Select from below:JKS Little Tigers - Ages 5-8 years old (Monday ONLY 5:00 - 5:45pm)JKS Little Tigers - Ages 5-8 years old (Thursday ONLY 5:00 - 5:45pm)JKS Little Tigers - Ages 5-8 years old (Monday AND Thursday 5:00 - 5:45pm)JKS General Karate Session - Ages 8+ (Monday and Thursday 6 - 7:00pm)JKS Senior Session - Purple belt+ (Monday and Thursday 6 - 7:30pm)

Previous martial arts experience, if any. Style and Grade achieved.

If happy with trial class, do you need to order a uniform (gi)?
YesNo

If "Yes" to ordering a uniform, please enter head-to-toe height (cm)

JKS NorthShore Karate club declaration:

By accepting I agree in the section below I do hereby submit my digital signature in my application for registration at JKS North Shore Karate.

1. I/We hereby acknowledge and accept the JKS North Shore Rules (terms and conditions).

2. I accept that Karate is a martial art, and as such, indemnify the JKS North Shore Karate Club and it’s instructors from any liability caused through injury or mishap that may occur during training and/or competition.

3. I endeavour to train with strong Karate spirit, to give my best effort, and to follow the dojo kune at all times.

4. The JKS North Shore Karate reserves full right of admission, and has the sole right and authority to remove any student(s) if deemed in the best interest of JKS North Shore Karate and its Dojos, either temporarily or permanently.

5. I accept that JKS North Shore Karate will, from time to time take pictures/video, of me/my child during classes or tournaments and hereby give permission for them to be used on social media, and in all other advertising/promotional media.

I agree with the Club Declaration