The Dojo Woking
Membership Form and Liability Waiver

First and Last Name

Emergency Contact Name

Mobile

Date

Emergency Contact Number

Choose class that interests you * Required

Koshiki Karate

K-1 Kickboxing

Muay Thai

Junior Kickboxing

Stretch Fitness

I confirm that I am in good health and do not put myself at risk by undertaking all levels of training at The Dojo Woking. *

Yes

From time to time we use photos and videos of our classes for promoton purposes online, in fliers, adverts and other printed promotional mediums. By ticking the box, I confirm that I give permission to The Dojo Woking to use this material where me or my child/children may appear.

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

I declare that the information that I’ve provided is accurate & complete

Select a Membership *

Month Fees One Class per Week - £45.00

Month Fees Two Classes per Week - £55.00

Month Fees Unlimited Classes per Week - £65.00

Signature of member over 18 or Parent/Guardian

Date of signing

info@thedojowoking.com

dojo Address:

11 Manor Way, Old Woking, GU22 9JX, Surrey, United Kingdom

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The Dojo Woking Membership Form and Liability Waiver

The Dojo Woking
Membership Form and Liability Waiver