Please fill out the following membership form to join or to to update your details if any have changed:

    New or Existing Member?


    First Name:

    Last Name:

    Your Email:

    Your Date Of Birth:

    Mobile Number:

    Home Number:



    Grade in Kore Kickboxing?

    Graded in any other style?


    If "Yes" then please supply the grade:

    If "Yes" then please supply the style:

    Emergency Contact Name: (Parent/Guardian for <16)

    Emergency Contact Number:

    Emergency Contact Relationship:

    Do you suffer from any medical conditions?


    If "Yes" then please supply information:

    Any Criminal Record Other Than A Driving Conviction?


    If "Yes" then please supply information:

    Any Additional Information?:

    Do you accept the following?


    - Fees, or portions of fees paid, are non-returnable, and non-transferable.
    - The club may be closed under certain conditions e.g. Public Holidays, Gradings, etc.
    - The club reserves the right to decline application or discontinue membership without reason.
    - Written medical clearance may be required for some medical conditions.
    - Under 16's must have a parent or guardian must meet with an official from the club.

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