Register

First Name *

Last Name *

Date of Birth (M/D/Y) *

Gender *
 Male Female

Street Address *

City *

Postal Code *

Phone Number *

Email *

Are you currently physically active (details)?

List any recent injuries (especially head injuries) or known health concerns that may affect your ability to practice Taekwondo safely:

Have you trained in martial arts before?
 Yes No

If yes, what type?

When?

How did you hear about our school?
 Friend/Family Flyer Sign Website Other

List some of your expectations during your training:

Emergency Contact Person #1*
Name:     
Phone:    
Relation:

Emergency Contact Person #2
Name:     
Phone:    
Relation:

Terms and Conditions of Registration

I, as a member of Adelphos Taekwondo Academy, pledge to abide by the following regulations and determine to take them as my goal of training:

1. To be loyal to my nation and to my parents
2. To be obedient to my instructors
3. To observe the school rules and regulations
4. To respect my seniors and practice patience and courtesy with my juniors
5. To be just and show good conduct

I hereby make application for membership in Adelphos Taekwondo Academy (herein “Adelphos”) and upon acceptance, I pledge to abide by all school rules and regulations, which were formulated for the purpose of keeping order in the school and for the protection of students from injury. I further acknowledge and understand that a risk of personal injury is involved that requires strict adherence to these rules and regulations and the instructor’s discipline.

In consideration of accepting this application for participation in the school’s activities, I, my heirs, executors and administrators, do hereby release Faith Evangelical Lutheran Church of Surrey, BC (herein “Faith”), and Adelphos, its instructors and authorized guests from all responsibilities and all claims for injury which I may receive while practicing or performing Taekwondo as a student of Adelphos.

Additionally, the parent or guardian of the applicant requests that this application be accepted, and in consideration of the acceptance, hereby agrees to indemnify Adelphos and Faith, its instructors and authorized guests, of and from all manner of claims made by or on behalf of the applicant.

I will conduct myself so that I will not disgrace the honour of the membership and I will not attempt to teach any of the techniques of Taekwondo elsewhere except with the expressed and written consent of Adelphos.

I further agree that images taken of me in connection with the school can be used for publicity or promotion without compensation at any time. I understand that I can withdraw my consent, in writing, at any time.

 I have read and understand all of the rules and regulations, including the school pledge, and I agree to adhere to these terms and conditions.

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