Surname Given Names Date Of Birth Nationality Address Post Code Tel (home) Mobile Occupation Email

Do you suffer from any illness or physical disability: yes no
If yes, please give details

Do you have any previous martial arts training: yes no
If yes, what style of martial arts & how long & rank

Please tick which membership

Student annual membership $48
School annual membership $128

Full name of school affiliate or student for membership

I would like to register and become a member of Zeus International Martial Arts Academy and hereby agree to abide by the rules and regulations of the academy.

1. I WILL BE HOUNARBLE & RESPECTFUL TO THE MASTER & ALL SENIOR INSTRUCTORS
2. I WILL BE LOYAL AS A MARTIAL ARTIST AND TO THE ACADEMY & INSTRUCTOR.
3. I SHALL BE SOLELY RESPONSIBLE FOR ANY INJURIES THAT MAY BE INCURRED DURING
THE COURSE OF TRAINING, AND FULLY WAIVE ANY, AND ALL CLAIMS FOR INJURIES AND DAMAGES.