Paisley School of Hung Fut Pai Kung Fu


Membership Information & Application Form

 

 

Name:

Sex:
Date of Birth:

Address:

Daytime Tel:
Evening Tel:

Emergency Contact Details:



Club Details (Relevant Previous Experience)

Club Attended:

When Started: Instructor:

Current Grade:

 

 

Signature: _________________________________ Date: ________________________

NOTE: THIS FORM MUST BE SIGNED BY PARENT OR GUARDIAN IF STUDENT IS UNDER 16.

SIGNATURE: _______________________________ DATE: _______________________

 

 

 

 

 

All Students

Please be aware that Martial Arts does involve physical excercise, is a contact sport and participation is entirely at your own risk.

In order to avoid unnecessary injury, you must make Chief instructors aware of any illnesses or conditions that could be affected by this activity. eg/ asthma, heart conditions, epilepsy, pregnancy, high or low blood pressure, joint or muscular pain/injuries etc.

In some cases we require you to obtain doctor's advice to take part in Martial Arts and provide evidence of such.

In order to cover both yourself and Paisley School of Kung Fu it is your responsibility to be aware of these rules and to ensure that you have taken the appropriate action to avoid any injuries. In extreme circumstances long term injuries could be sustained which could result in death.

If at any time you do not wish to participate in any activity within the class then you have the right to practice any other part of the syllabus.

It would be helpful if you could complete the section below for our records, detailing any current conditions and/or medication that you are currently taking.

Name:

Condition/Injuries:


Medication:


Any other relevant information e.g./allergic reactions etc.


Signature: _________________________________ Date: ________________________

NOTE: THIS FORM MUST BE SIGNED BY PARENT OR GUARDIAN IF STUDENT IS UNDER 16.

SIGNATURE: _______________________________ DATE: _______________________


Please print this form and give to your instructor.

You are not required to disclose the above information but please be aware that participation in Martial Arts is entirely at your own risk

 

 

 

 

 

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tel: Sifu Iain Paterson - 07792 980375
email: iainpaterson71@hotmail.com
www.paisleykungfu.com