Casey Taekwondo Center Registration
Athlete's Name
Birth date
Gender
Male
Female
Other
Current Level
White belt (beginner)
Coloured belt
Black belt
Other
Parent/Guardian Information (if athlete is under 18)
Alternative Emergency Contact
Does the athlete have asthma, allergies, or any other medical condition?
Membership
Membership Type
Opening offer: 3 classes + free uniform for $19.99
Term pass: 10 classes per term for $100
Unlimited training: Up to 2 classes per week for $19.99/week
Personal instruction: Price as agreed
Payment Option
Cash
Online payment
Direct debit
Acknowledgement
I understand that all sports carry a risk of injury and that Mozhdeh Martial Arts is not responsible for injuries or loss suffered. In the event of an injury, I allow Casey Taekwondo Center to provide first aid and authorize medical treatment.