Attack Box Taekwon-do

Membership

Registration Form

Complete the form below to begin your Taekwon-do journey with Attack Box Taekwon-do.

Personal Information

Surname

First Name

Address Line 1

Address Line 2

Date of Birth

Mobile #

Work #

Email Address

Occupation

Company / School

Company / School Address Line 1

Company / School Address Line 2

Emergency Contact (1)

Full Name

Relation to Student

Mobile Phone

Work Phone

Email Address

Emergency Contact (2)

Full Name

Relation to Student

Mobile Phone

Work Phone

Email Address

Waiver & Signature

Participation in any training session or club activity does not make students or instructors responsible for any physical or psychological injury incurred as a result of aforementioned participation.

I have read and agree to the above waiver statement. *

Signature of Applicant

Date of Application

Media Consent *

I consent to photographs and/or videos taken of me during training sessions or competitions being used by Attack Box Taekwondo for promotional purposes, including publication on social media, websites, and other marketing materials.

I do not authorize photographs or videos of me to be used on social media, websites, or any promotional materials.

Please select one of the options above to continue.

Please agree to the waiver and select a media consent option to continue.