UTA Enrolement Form

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Register with UTA & LBTKD Taekwon-Do

Class Selection*

Adult or Child Registration*

Student Information

Students Name*

First Last

Parents Name

First Last

(if under 18yrs)

Email*

Nationality*

Gender*

Date of Birth*

Contact Number*

Registered Address

House Name / Number*

Street*

Village / Town*

Post Code*

More Information

Past Martial Arts Experience (if any)

How did you find out about our Club?

Have you ever been convicted of a criminal offence?*

Yes

Criminal Offence Declaration

Health Information

Please tick any conditions you have

Heart Disorder

Haemophilia

Asthma

Hayfever

Migraine

Diabetes

Nervous Disorder

Epilepsy

Autistic

Other Condition (if relevant to your training)

Other Conditions

Under the Equality Act 2010 disability is described as a physical or mental impairment that has substantial and long-term negative effect on a person’s ability to do normal daily activities. Do you consider yourself/your child to have a disability that we should be aware of?

Yes

Other Condition (explained)

Emergency Contact*

First Last

Phone number of emergency contact*

Agreements & Terms

Your Agreement*

I agree to abide by the rules and regulations of the BTC/UKITF/UTA

I understand that you collect and hold GDPR sensitive Data, essential medical information in order to conduct risk assessments and monitor the wellbeing of participants. By signing I give consent for this information to be stored. You can view our GDPR Statement and Privacy Policy here.

Medical Treatment*

I consent to basic medical treatment

If we have agreed with you in advance, that we can administer medicine IF required (e.g hayfever, asthma inhaler), please give us consent here

Photography*

I DO give consent

I DO NOT give consent

(Parent / Guardian if under 18yrs). I am aware that photographs will be taken during the Taekwon-Do training/events for promotional purposes, and give consent for my child to feature in such photos

Club Mailing List*

Yes, Add to Club Mailing List

No, I understand I will miss important information

I wish to sign up to the club mailing. I understand that this will only be used for the purposes of TaeKwon-Do. I understand that if I do not want to sign up I will miss important information about my/my child’s training

Signature*

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UTA Enrolement Form

UTA Enrolment Form

Register with UTA & LBTKD Taekwon-Do

Student Information

Registered Address

More Information

Health Information

Agreements & Terms

Anti Spam (Tick the Box)

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