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Participant Agreement and User Registration
Please complete all required fields!
First Name
(*Required*)
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Last Name
(*Required*)
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Middle Names (optional)
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Postal Address (including postcode)
(*Required*)
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Date of Birth
(*Required*)
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E-mail (your email address will be your username)
(*Required*)
Please provide a valid e-mail!
Verify E-mail
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Password
(*Required*)
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Verify Password
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Contact Number
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Occupation
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Employer
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Previous Martial Arts / Sports Experience (optional)
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Are you qualified in First Aid?
(*Required*)
Yes
No
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Emergency Contact Name
(*Required*)
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Emergency Contact Number
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Do you have any allergies that we need to be made aware of?
(*Required*)
Yes
No
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If yes what are the details of the allergy and do you have an EpiPen if required?
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Are you taking any prescribed medication which may impair reaction time or judgement?
(*Required*)
Yes
No
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If yes what medications?
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Have you suffered a concussion or head related injury in the past 12 months?
(*Required*)
Yes
No
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If yes please provide details and have you received a medical clearance to train?
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Are you aware of any health related problems that you have had that, in the interest of you and fellow students, that the club should be made aware of?
(*Required*)
Yes
No
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If yes please provide details
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If you are the Guardian of Child Participants, please write their Names and Ages here
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You can find Swordpoint Code of Conduct here
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Declarations
(*Required*)
I agree that I will not attend any class whilst under the effects of drugs or alcohol and that if I do I may be asked to leave.
I understand that Martial Arts in all forms are dangerous and that I will abide by the club's codes of conduct and conduct myself safely at all times.
I agree that in any form of sparring that I will not use excessive force and will always use the appropriate safety equipment.
I agree that the terms and conditions may change in the future and that I am bound to and agree to any changes which may arise as they arise.
If I am under 18 I certify that I have my Guardians Consent.
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Without expectation of compensation or other remuneration, now or in the future, I hereby give my consent to Swordpoint College of Arms, its affiliates and agents, to use my image and likeness and/or any interview statements from me in its publications, advertising or other media activities (including the Internet). This consent includes, but is not limited to: (a) Permission to interview, film, photograph, tape, or otherwise make a video reproduction of me and/or record my voice; (b) Permission to use my name; and (c) Permission to use quotes from the interview(s) (or excerpts of such quotes), the film, photograph(s), tape(s) or reproduction(s) of me, and/or recording of my voice, in part or in whole, in its publications, in newspapers, magazines and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for educational and awareness. This consent is given in perpetuity, and does not require prior approval by me.
Signature
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Clubs and Locations
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Swordpoint Social
First Timer Questionnaire
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