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Membership Activation Form
Please use the following form below to activate your membership with us.
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1
Student Full Name
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Name of student applying for membership
First Name
Last Name
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2
Contact Email
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So we can contact you with relevant information. We will not add you to any mailing list.
example@example.com
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3
Contact Phone Number
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Please provide a contact phone number
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4
Emergency Contact Name
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Please provide the name of a person we contact in case of emergency
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5
Emergency Contact Number
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Please provide the contact number of a person we contact in case of emergency
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6
Student Date of Birth
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Required for safeguarding and Insurance purposes
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Date of Birth
Year
Month
Day
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7
Dragons Academy Uniform and Equipment
*
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All member students at Dragons Academy are required to wear our academy uniform whilst training. This consists of a black Dragons Academy T-Shirt (RRP £15.00) (name on shirt optional) with black martial arts with yellow stripe (RRP £12.99). All member students graded at Orange belt and above will also be required to have their own Head Guard, Gum Shield, Sparring Gloves to participate in sparring sessions.
I understand the above Dragons Academy uniform is to be ordered as part of my membership
I understand all members graded Orange belt and above need to have their own protective equipment for sparring sessions.
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8
International Taekwondo Council Martial Arts Insurance Cover
*
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All member students at Dragons Academy are required to have Martial Arts Insurance for their safety and the safety of others. Our insurance is provided via the ITC who provide annual cover at the cost of £20.00 per year. Upon completion of this form you will be required to register for the required Insurance. Please note having no insurance cover will cancel your membership
I understand as a requirement of membership I require the relevant insurance cover
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9
Standing Order and Bank Payment Instructions for training fees
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To apply for our academy membership you are required to set up a standing order payment for the first day of each calendar month to cover your monthly training fees. Starting from the month following your free trial a training fee of £25.00 GBP (twenty five pounds) is to be paid on the first calendar day of the month to cover your training fee for the calendar month the payment is received. I.e payment on 1st March is for March payment. Members will be given 7 days to make their monthly payment before their membership for that month is terminated. Bank Details provided below for all payments. Sorry we do not currently accept cash payments at this time. Account Number: 00626361 Sort Code: 115205 Account Name: Terry Walton
I have set up the required standing order to pay the required £25.00 monthly training fee on the first of every calendar month following the free trial month
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10
Membership Agreement Terms and conditions
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Payments that are not received for whatever reason will terminate your membership for that month until the standing order is received. It is your responsibility as the person setting up the standing order to ensure you are paying the correct amount on the correct dates, any error on your part will not allow for a refund of over payments to be made. Membership refunds are not given other than in case of error on our part. If you are injured or have a long term illness and unable to train please contact us immediately by email (dragons.academy@outlook.com) informing us that you will be pausing your standing order, then inform us when you wish to restart your membership and reactivate your standing order. You will still need to pay for every grading, technical seminar or competition you attend at the appropriate tariff. If you wish to cancel your membership and standing order notice is to be given in writing to Dragons Academy informing us you wish to cancel your membership. Please contact us by email (dragons.academy@outlook.com) with at least a 1 month notice period that you wish to terminate your membership and will be stopping your standing order. An acknowledgement of your cancellation will be emailed to you. Dragons Academy have the right to cancel your membership at any point if you are proven to have breached any of our club code of conduct rules or policies. This includes not having the relevant martial arts insurance cover or adequate protective equipment. Students who are under the age of 18 years of age will need a parent or guardian to accept the membership on their behalf.
I have read, understood and accepted the terms and conditions for membership.
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