First Name (required)

Surname (required)

Time and Day of first intro (required)

DOB (required)

Sex: (required)
MaleFemale

Your Email (required)

Mobile

Address

Suburb

Postcode

Parents names (for children)

How did you find us? What advertising have you seen?

Name of person referring you?

Do you have any injuries, medical conditions or disorders that we should be aware of (no if none)?

By continuing I understand a condition of acceptance of my enrollment in the above organization for myself, my heirs, executors and administrators, hereby waive all and any claims, fight of cause or action, which I or they might otherwise have arisen out of any loss of life or injury, damage or loss of any description whatsoever which I may suffer or sustain in the course of or consequent upon my participation in any activities associated with the said organization. This waiver, release and discharge shall be and operates separately in favor of all persons, corporations or bodies involved or otherwise engaged by the said organization. I understand that although every effort is made to ensure that the training is safe, that martial arts training has some inherent risk. I agree to accept full responsibility for these risks. If I am accepted as a student in this dojo and I shall do my best to uphold the good name and principles of this dojo and Shiryodo Karate. UNIFORM AGREEMENT when issued with a uniform for introductory lessons this remains the property of Shiryodo Karate and must be returned if not enrolling after the introductory program. I agree to return uniform or pay cost of uniform if I do not enroll after the introductory classes.

2 intro classes with uniform - $29 (uniform not included if doing online, contact us for options to have uniform mailed) .
NOTE: EITHER PAY ONLINE WITH FORM AFTER SEND OR WHEN ATTENDING.