Book a Free Trial Aikido Class | Student Registration

Student Profile

Student First Name *

Student Last Name *

Student Date of Birth *

Gender *

Class *

Preferred Start Date (Optional)

Residential Address *

Suburb *

State *

Postcode *

Contact Email *

Phone Number *

Reason for Training (Optional)

Are you signing up for a free trial class?

Trial Class Terms & Conditions

Please Read Carefully:

There is only 1 (one) free class available per person.
This offer is valid ONLY for new students who have never trained with our dojo before.
This offer is subject to availability and can be changed or revoked at any time without prior notice.

Ready to start your journey? Fill out the form below to reserve your spot on the mat. Wear loose, comfortable clothing (like a t-shirt and track pants) and bring a water bottle.

I confirm I have never trained at this dojo before. *

I have previously trained in Martial Arts.

Years of Training *

Style(s) Trained *

Parent / Guardian Information

Parent / Guardian First Name *

Parent / Guardian Last Name *

Parent / Guardian Relationship *

Parent / Guardian Phone *

Parent / Guardian Email *

Parent / Guardian is also the primary Emergency Contact (Next of Kin).

Emergency Contact (Next of Kin)

Emergency Contact Full Name *

Emergency Contact Phone *

Safety & Medical Declaration

Do you have current ambulance insurance? *

Yes No

Are you prescribed any drugs that may impair reaction time? *

Yes No

Please describe (Required):

Do you have any known allergies? *

Yes No

Please describe (Required):

Will you be carrying any life-saving medications (e.g., EpiPen)? *

Yes No

Please describe (Required):

Any incapacity in the last 12 months? *

Yes No

Please describe (Required):

Physical impairments or medical conditions? *

Yes No

Please describe (Required):

Any mental health issues to advise? *

Yes No

Please describe (Required):

Ever been excluded from physical activity? *

Yes No

Please describe (Required):

Consents & Agreements

Release and Indemnity Agreement

I am aware that Aikido is a martial art and hence certain traditions and principles must be understood and observed at all times. The practise of Aikido involves an element of danger and unpredictability and permanent and serious injury could possibly result from the participation in Aikido practise.

I freely accept and fully assume all such risks, dangers and hazards and the possibility of personal injury, death, property damage or loss resulting from such risks, dangers and hazards.

I hereby agree as follows:

TO ASSUME AND ACCEPT ALL RISKS, DANGERS AND HAZARDS in connection with the practise of Aikido.
TO WAIVE ANY AND ALL CLAIMS that I may have against Aikido South Kingsville Dojo, their directors, officers, employees, agents and representatives.
TO RELEASE Aikido South Kingsville Dojo from any and all liability for any loss, damage, injury or expense that I, or my next of kin, may suffer or incur as a result of my actions due to any cause whatsoever, INCLUDING NEGLIGENCE ON THE PART OF Aikido South Kingsville Dojo.
TO HOLD HARMLESS AND INDEMNIFY Aikido South Kingsville Dojo from any and all liability for property damage, personal injury or death suffered by myself or by a third party as a result of (a) my use of the facilities and/or (b) my breach of the terms and conditions upon.
THAT THIS RELEASE AND INDEMNITY AGREEMENT shall be effective and binding upon my heirs, next of kin, executors, administrators, ad assigns, in the event of my death;
TO OBEY all warning signs and other notices posted within the facilities and to obey the Code.
Carefully follow the training instructions, dojo rules for etiquette and safety at all times during my practise of Aikido.
I am not required to perform any techniques or practise in any situation, which I consider to be unsafe, in which case I agree to notify the instructor immediately of my concerns.

I further represent that I am able to participate in and undertake physical exercise and I am not aware of having any physical, medical, mental or health disability or conditions or disease which might or could be aggravated or worsened by physical exercise or which might or could result in deterioration of health if physical exercise is undertaken.

Comments (Optional)

Student Registration & Trial Class

Student Profile

Trial Class Terms & Conditions

Parent / Guardian Information

Emergency Contact (Next of Kin)

Safety & Medical Declaration

Consents & Agreements

Release and Indemnity Agreement

Osu! Registration Received