Golden Kick Taekwondo Cayman Islands

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With the exception of medical emergencies, no information will be disclosed to a third party without the consent of the applicant or his/her parent/legal guardian.

GOLDEN KICK TAEKWONDO Membership Registration Form

Name:

Date of Birth:

Parent's Name (if under 18):

Phone # (Parent's Phone #, if under 18):

Email (Parent's Email, if under 18):

EMERGENCY CONTACT Name (else then mentioned above):

Relation:

Contact #:

Where did you hear about GKT? (tick all that apply)

Do you have any health conditions (ie. medical conditions, allergies, on medications, injuries, concussions, etc.) that would potentially cause you difficulty when taking part in activities held by GKT?

YES

If answered YES, please explain. Physician letter may be required.

Free Text

With the exception of medical emergencies, no information will be disclosed to a third party without the consent of the applicant or his/her parent/legal guardian.

*) "My Child" applies when the applicant is under 18

By submitting this form, I hereby make an application for membership of myself/my child*) with the GKT, and I fully understand and agree to the following:

I represent to the GKT that I have taken all reasonable steps to determine, and hereby warrant, that I/my child*) is in good health and physically capable of participating in the programs offered by the GKT. I acknowledge that the GKT shall not have responsibility to OR make any independent evaluation of my/my child’s*) physical health or fitness; AND
I am fully aware that in participating in this activity, there are some inherent risks attached to it that may cause injury to a person or damage/loss to property both on and off the premises of the GKT. I understand and agree that all participation in any such fitness program or use of the GKT's facilities or equipment on or off the premises of the GKT shall be at my own risk; AND
My/My child’s*) presence and activities are completely at my own risk and I do hereby indemnify, release, and forever discharge the GKT, its owners, instructors, directors, members, volunteers, or any other person connected with the said GKT against all liability and responsibility from all claims for personal injury and/or any loss of personal property or injuries or damage to person or property while engaging in activities/programs held by the GKT, including travel to and from the training sessions, taekwondo competitions, when traveling for competitions, or any other scheduled team activities, whether or not damages or loss due to negligence; AND
I agree to pay my membership and term fees in full and in accordance with the regulations set down concerning such fees, and that the fees will cover the term for that period only, and that no credit or refund shall be made should I not attend classes for whatever reason, unless special arrangements have been made with the GKT’s administration; AND
That any photographs taken of me/my child*) in connection with the GKT may be used for publication or promotion without compensation at any time; AND
I have read and understood this document and I am aware that by submitting this form, I am waiving and giving consent to certain legal rights that I or my heirs, next of kin, executors, or assigns may have against the GKT.
I certify that the above information provided is accurate.

CONTACT

Phone:
+1 (345) 547 5678

Email:
info@goldenkicktaekwondo.com

Address:
86 Mary Street
George Town, Grand Cayman
Cayman Islands
(Across from the WORC, Apollo House)

OPENING HOURS

Mon - Fri: 3:00 pm - 8:00 pm
Saturday: 10:00 am - 2:00 pm
Sunday: Appointment Only

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