Please complete this application to apply for or renew your membership to the Centre for Martial Arts & Human Development Inc (of which the Kodokan Cummings Karate Dojo is a part of) herein referred to as 'the Association'.

You must fill out one application per person, and for children it must be in the student's (not parent's) name.

By completing this form, you agree to the following Terms & Conditions:

  1. I hereby apply for membership to the Association. In applying, I agree to be bound by the Association's constitution, all rules and regulations of conduct, and policies as specified by the Association (found at: http://www.karatecanberra.com.au/resources/policies/). I understand that the Karate and Kobudo (Weapons) instruction given by the Association is a fighting and contact art and all care is taken to ensure that such instruction is conducted in a safe manner.
  2. I confirm that I have completed a pre-activity questionnaire and indemnity waiver disclosing a full medical history and any problems arising from pre-existing medical conditions. I agree to notify the Association of any changes to those medical conditions before my next training session. I agree to also note any changes on my Membership Application when I renew each year. I also confirm that should I be allergic to anything, I have noted it on my medical form and provided a medical action plan to the Association.
  3. I understand and agree that the Chair of the Association shall at all times have the sole right to determine whether or not I am complying with the Associations Rules and Regulations and conducting myself with due care, restraint and correct behaviour.
  4. I agree, unless otherwise stated on this application, to allow my photo/video of me to be taken during class and posted on our dojo pages (including, but not limited to our website and Facebook), and also used on promotional material.
  5. I understand that my fees are calculated on an annual basis, and are charged over 12 payments per year from January to December and include the holiday/break periods. Training fees can be cancelled at any time, but notice must be given by the 20th of the month prior. Cancellations must be made via completing the form at http://www.karatecanberra.com.au/cancel/. I understand that all fees, once paid, are non-refundable.
  6. I give permission for the Association, via the payment provider, to debit from my nominated payment method the Enrolment Fee and the reoccurring Monthly Training Fee, as outlined in the Fee Schedule, until I cancel the debits in accordance with Condition 5. For further information, please see the Fee Payment Policy at http://karatecanberra.com.au/resources/policies/
  7. I understand I will undergo a probation period, which is determined to be finished once I attain my first grade.
  8. I understand I am required to follow dojo etiquette at all times, listed at http://karatecanberra.com.au/resources/dojo-etiquette
  9. I understand that these Terms and Conditions may be varied, without notice, from time to time, and accept those changes.

MEMBERSHIP & TRAINING FEES
On joining the dojo, I understand I will be charged an Enrolment Fee (Individual - $95, Family of 2 - $140, Family of 3 or more - $180), and then a regular training fee each month (as shown below). Click here to view our full Fee Schedule. After completing this form, you will receive an email asking you to complete our payment form (via Stripe).

IMPORTANT NOTE FOR MOBILE NUMBERS & EMAILS
When completing the 'mobile' field, please complete using the following format: 614<number> - for example: 61429392785 (no spaces or dashes, and replace the 0 with 61). This is to ensure you can receive text messages from our automated system.

ATTENDANCE REQUIREMENTS
All students are required to regularly attend two classes per week. We do not offer once a week programs. We are dedicated to offering our students quality instruction and experiences, and over the years of teaching, we have found that once a week is simply not enough to build memory recall and learn efficiently.

PROGRAM OPTIONS

Note for those joining the Kobudo Program:The Kobudo Program has a separate uniform (black). This is not required until doing your first formal Grading, but most students purchase it on enrolment. Weapons are available for communal use in the Dojo, but there is a discounted Kobudo package included below, otherwise, these can be purchased at a later date.

First name:
Last name:
E-mail:
Email 2:
Mobile:
Phone 2:
Emergency Contact & Number:
Date of Birth:
Gender_prev:
Street No & Name:
Suburb:
State:
Postcode:
Medical notes:
Full-time uni student ID# ($10 discount):
Do you agree to all terms and conditions?:
What Program(s) are you enrolling in?:
Which days will you attend class (Mo/Tu/We/Th)?:
Kobudo Starter Pack:
Student's Height in cm (for uniform size):
Would you like any additional Dojo Apparel - This will be charged with your Enrolment Fee: