MARTIAL ART
INSTITUTE INTERNATIONAL
MEMBERSHIP APPLICATION FORM
Licence No. ___________________
Membership No. : _____________ Occupation:______________________________
Name: _________________________________________________________ Date of Birth: __________________________
Address: __________________________________________________________________________________________________
Email:____________ Telephone: ____________________________________
Emergency
Contact Person: ___________________ Relationship:________ Telephone: _____________________________
General
Practitioner: ________________________ Address: _____________________________________________________
_________________________________________________________________ Telephone:
_____________________________
Criminal Record (if applicable): _____________________________________________________________________________
Why do you wish learn martial arts? __________________________________________________________________________
Where did you hear about this club? __________________________________________________________________________
Any previous martial arts
experience? _________________________________________________________________________
HEALTH (Please delete as appropriate Yes/No)
Have you ever suffered from: Details
1. Heart
Disease or any other cardio-vascular problems? YES/NO _________________________________________
2. Do
you have high/low blood pressure? YES/NO _________________________________________
3. Is
there a family history of heart disease? YES/NO _________________________________________
4. Pain
or tightness in the chest? YES/NO _________________________________________
5. Diabetes? YES/NO
_________________________________________
6. Epilepsy? YES/NO _________________________________________
7. Asthma
or breathing difficulties? YES/NO _________________________________________
8. Back
pain/Joint discomfort? YES/NO _________________________________________
9. Which
joint(s) is made worse by exercise? YES/NO _________________________________________
10. Osteoarthritis
or Rheumatoid Arthritis? YES/NO
_________________________________________
11. Do
you have varicose veins? YES/NO _________________________________________
12. Have
you been treated by a doctor in the last 6 weeks? YES/NO _________________________________________
13. Do
you have any visual or hearing impairment? YES/NO _________________________________________
14. Have
you been in hospital or had any operations recently? YES/NO _________________________________________
15. Are
you taking any drugs or medication? YES/NO _________________________________________
16. Have
you any medical condition which you think might
interfere
with your participation in martial arts training? YES/NO _________________________________________
17. Have
you been told by a doctor that you are overweight
or
underweight? YES/NO _________________________________________
18. Do
you smoke? If, so, how many? YES/NO _________________________________________
19. Do
you drink more than 1 bottle of wine/6 pints beer
6
glasses of spirit a week? YES/NO _________________________________________
20. Are
you physically active at work or outside? YES/NO _________________________________________
21. What
sporting activity do you participate in at the moment and how often?
___________________________________________________________________________________________________
22. Is
there any other aspect concerning your health you think the instructor should
know about?
___________________________________________________________________________________________________
RULES
1.
Martial
Arts’ skills must not be used outside the club (Kwoon) or sporting arena
against any other person with intention to cause injuries except under the
circumstances of self-defence either to protect property or personal safety.
2.
Under
self-defence situation, only reasonable force must be used as defined by the
Court of Law.
3.
The
martial arts licence must not be abused to justify carrying offensive weapon(s)
in the public other than transporting it to and from the club for the sole
purpose of training.
4.
Uniform
must be worn during training, examination, competition or any official
representation of the Martial Art Institute International.
5.
All
participants must have insurance cover or licence by a national recognised
governing body or reputable insurance company.
6.
Traditional
sign of respect must be displayed when entering or leaving the club (Kwoon).
7.
Always
pay your respect to your opponent before and after training.
8.
Address
your instructor according to the Kung Fu tradition as Si-Fu.
9.
No
foul language arising from bad temper is permitted in the club (Kwoon).
10.
Bad
attitude and temperamental behaviour that may cause offence to the instructor
(Si-Fu) or the class will result in immediate termination of membership of the
Martial Art Institute or club.
11.
Ensure
the training area is clean and tidy after use.
12.
Make
sure your instructor (Si-Fu) is updated with any illness or injuries you may
have.
13.
Tuition
fees must be paid in advance each month; it is non-refundable and will not be
credited for any period of absence. **Note** read joining up conditions. Prices are subject to change during the course of the yearly
membership, and advance notice will be given.
DECLARATION
I declare that to the best of my knowledge the
information given is correct and that I know of no reason why I should not
participate in martial arts training. I
have read and agree to abide by the rules and conditions of the Martial Art
Institute and I am aware that breach of the rules or conditions may result in
termination of membership. I understand
that I enter into any exercise programme entirely at my own risk and I waive
any legal recourse for damages to myself that may arise from my
participation.
Signed: __________________________________________________________ Date: __________________________________
Approved member (Official signatory): _______________________________
Date: __________________________________
Official Comments:
_________________________________________________________________________________________
All cheques payments made payable to ‘HEI CHOI’, PO Box 628, Richmond, Surrey,
TW9 1FF.