ENROLLMENT FORM  -  SOUTHSIDE TAEKWON-DO

DOB:                                                              Surname:   

Gender:                                                         Given Names:         

Occupation:                                                  Enrolling Club:  TUGG/CHIS/WEST      

 Address:                                                       post code:

Phone (H):                                                     Phone (Mob/Work):                               

Email:

Details of any Medical Conditions:

Please attach any relevant documents

The following section to be completed by Parent/Guardian if under 18

       I,      (Student's Name):                                                                                 agree to the following :

1.       I agree to pay all due fees at the beginning of each month, and acknowledge that I am not entitled to any discounts for failure to attend classes or events. Such discounts are approved in advance and under no circumstances will discounts be given for absence of less than two full weeks.

2.       I accept that misconduct, or any behaviour bringing disharmony or discredit to the art and to Southside Taekwon-Do is viewed seriously and will, if the Instructor so decides, result in the immediate dismissal of the student without recourse of any kind.

3.       In consideration of Glen McKinnon, also trading as Southside Taekwon-Do, agreeing to accept me to train and participate in all activities to do with Taekwon-Do, I acknowledge that I do so entirely at my own risk and shall not hold my Instructor, club or parent body in any way responsible for accident, loss or injury of any kind. I acknowledge that I am participating in a body contact activity and that whilst every endeavour will be made to ensure my welfare, there is always a risk of bodily injury. The organisation I am now joining shall not be responsible in any way, implied or otherwise, for any claims arising out of membership of the aforesaid organisation.

4.       I shall obey all instructions given to me by the Instructor or an appropriately delegated senior.

5.       I agree to abide by all rules and requirements pursuant to membership of Southside Taekwon-Do, and I agree to the enrolment fee of $50 which is enclosed herewith.

6.       I agree to abide by all decisions given after gradings.

Signature of Student:                                                                                 Date:

Signature of Parent/Guardian:                                                                   Date:

Relationship with Student (eg Mother):

Signature of Witness:                                                                                 Date:

PRIVACY NOTICE

The information in this form is collected on behalf of Southside Taekwon-Do. Some of the information may be personal information as defined by the Privacy Act 1988.  The purposes for which the information is collected include notifying our insurers and legal advisors of injuries and ensuring that Southside Taekwon-Do itself has accurate and complete records.  If a claim is lodged, Southside Taekwon-Do may provide information from this form or any other information relevant to the accident/incident to its insurers and legal advisors.

Information will be stored, used and disclosed in accordance with the Privacy Act 1988 and the Freedom of Information Act 1989.