HOME
ABOUT
Training
Order Equipment
Testimonials
Videos
Class Terminology
Karate Etiquette
Grading Criteria
Karate for Beginners
Fees
Student Licence/Insurance/Pre- Training Questionnaire-
Blog/Gallery/Videos
Privacy Policy
COVID-19 Guidelines for Class
Your Feedback
Special Events
LOCATIONS
EAST LONDON
>
-- All Classes --
Chingford
Edmonton
Homerton
Plaistow
Poplar
Poplar-Westferry
Walthamstow
* PRIVATE TUITION *
~ Karate Training Videos ~
Buy Equipment
KENT / S.E. LONDON
>
Belvedere
Blackfen
Dartford
Eltham
Orpington
SOUTH LONDON
>
Clapham
New Malden
Wimbledon
SOUTH-WEST LONDON
>
Addlestone
Bedfont
Hounslow
WEST LONDON
>
Acton
Ealing
Greenford
Harlesden
Northolt
Stonebridge
West London Insurance Application
West London Pre-Training Questionnaire
Order Equipment
CONTACT
Dmitriy - East London
Aaron - Kent / SE London
Kevin - South London
Peter - South-West London
Eddie - West London
BOOK CLASS
๐ SEARCH
Student Licence and Insurance Application
Annual Insurance and Licence Fee valid until 18th December 2023. In order to adhere to national governing policies, Kenshukai Karate is required to renew their member to member insurance for all students, this is an annual fee of £22.
Student Licence and Insurance Application West London 2022/23
*
Indicates required field
Select One
*
Existing student
New student
Student name
*
First
Last
Address
*
Phone Number
*
Email
*
Date of Birth
*
Class location attending/Dojo
*
Medical History (Do you suffer from any of the following)
*
None
Allergies
Asthma
Diabetes
Epilepsy
Haemophilia
Heart Disorder
Hay Fever
Nervous Disorder
Respiratory Disorder
Migraine
Joint/Skeletal
HIV
Other
Additional Details
*
Criminal History (Have you ever been charged or convicted with any crime of violence?
*
No
Yes
Please give details
*
Photography and Video
In accordance with the Good Practice Guidelines for use of photography and video, it is suggested that written consent be received from all parents or guardians when taking photographs or videos of children. Kenshukai Karate UK is committed to ensuring good practice is followed in relation to photography and video use within martial arts activities. This includes adherence to safe storage guidelines, as outlined in our Welfare Policy.
I consent to involvement in martial arts activities being photographed or recorded on occasion and for these images to be viewed and displayed.
*
Any of the below
Within the premises e.g. notice boards
In promotional material e.g. a flyer
On websites
Data Protection
I understand that this form will be sent to Kenshukai Karate UK for my student license to be processed and my information used in accordance with Kenshukai Karate UK Privacy Policy. I CONSENT to being contacted via
*
Any of the below
Email
Telephone
Text
Declaration
I declare that the following information is true and correct, and that I will abide by the policies and procedures as laid down by Kenshukai Karate. I accept that the practise of any martial art/combat sport involves the risk of serious injury.
*
Agree
Parent/Guardian name if under 18
*
Submit