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MACARTHUR MARTIAL ARTS KYOKUSHIN

2026 Membership Application Form

Date of Birth
Day
Month
Year

Medical Information

Do you suffer from, or are you affected by any medical condition or communicable disease?
Yes
No
Do you have any allergies?
Yes
No
Are you currently taking any medications?
Yes
No

Emergency Contact Details

Privacy Collection Statement


Macarthur Martial Arts Kyokushin collects the personal information requested in this application to process your membership, administer classes and activities, communicate with you, manage payments, respond to emergencies, and comply with legal obligations. Health information is collected only where necessary to help provide a safe training environment. Your personal information will be handled in accordance with our Privacy Policy, which is available on request and on our website www.macarthurmartialarts.com.au


MEMBERSHIP TERMS & CONDITIONS


I make application to become a member of Macarthur Martial Arts Kyokushin and Matsushima Kyokushin Australia NSW Inc. and to participate in classes, training, sparring, gradings, tournaments, training camps and other related activities (collectively and individually referred to as Activities) organised or promoted by David Berthon, Clare Berthon, Macarthur Martial Arts Kyokushin, Matsushima Kyokushin Australia NSW Inc. (MKA NSW Inc.), the International Karate Organisation – Matsushima (IKO), their subgroups and the trainers, instructors, members and persons associated with them (collectively and individually referred to as the Providers).


I understand that Kyokushin Karate is a high-intensity contact sport involving physically demanding activities that, if performed incorrectly, may be dangerous and detrimental to my health and can result in serious injury or death. Injuries can occur, and have occurred in the course of the Activities. I acknowledge that I participate in all Activities entirely at my own risk and assume full responsibility for any injury, loss or damage that I may sustain, or that I may cause to others, whilst participating in any Activities. I acknowledge that I am responsible for my own actions and involvement.


I acknowledge that training, while conducted under qualified supervision, involves physical contact and inherent risks, and I voluntarily accept those risks. I agree to conduct myself in a safe, respectful and mature manner and in accordance with the directions of my instructors. I indemnify the Providers, their proprietors, agents, officers, instructors, staff members and students against any loss or damage suffered by them in connection with my participation in the Activities.


I confirm that, other than as disclosed in this application, I have no existing physical or medical condition, disability or illness that may:

  • endanger my or another person's health or wellbeing;

  • be adversely affected by participation; or

  • be transmitted to another person,

during my participation in the Activities.

I agree to notify the Providers in writing if any such condition arises after the date of this application.


I agree to abide by all rules communicated to me and to follow all reasonable instructions given by the Providers.

I agree to pay the prescribed fees for participation in the Activities. I acknowledge that these fees may change from time to time upon notice being provided.


Cancellation of Membership

When cancelling my enrolment, I agree to provide 14 days' written notice. If less than 14 days' written notice is provided, I agree that a cancellation fee equal to two (2) weeks' training fees will be payable.


Cancelled or Missed Classes

If a scheduled class is cancelled by the Providers, or if I am unable to attend my usual class, I may attend another suitable class during the same week where available. No refunds or credits will be provided for cancelled or missed classes, regardless of whether I attend an alternative class.


Direct Debit Pauses

I understand that any pause to direct debit payments requires two (2) weeks written notice and must be for a minimum period of 14 consecutive days. I also acknowledge that the normal training timetable may be reduced during government school holiday periods and will be closed on NSW public holiday weekends.


I acknowledge that the Providers shall not be liable for any loss, damage, injury or any incidental, indirect, special, consequential or economic loss (including loss of opportunity, exemplary or punitive damages), whether to person or property, arising from default, negligence, misconduct or otherwise. I indemnify the Providers against all such claims to the fullest extent permitted by law.


Member Conduct

I agree that I (and/or my child) will conduct ourselves in an appropriate manner at all times and will act in the best interests of the Providers.

Any conduct considered inappropriate may result in disciplinary action, including suspension, removal from the premises, refusal of future enrolment, or termination of membership. The Providers reserve the right to refuse or terminate membership where behaviour is considered unacceptable. Any such decision shall be final, and there shall be no right of appeal.


Photography and Recordings

I consent to photographs and/or video recordings being taken during classes, gradings, tournaments, seminars and other Activities for promotional or educational purposes, including publication on the official website, Facebook page and other official social media platforms. If I do not consent, I agree to notify the Providers in writing before participating.


Parent / Guardian Supervision

Parents and guardians are responsible for supervising children aged under 18 years whenever they are not directly participating in a supervised class. This responsibility includes supervising children while travelling between the dojo and the car park.


The Providers and staff members are unable to supervise children before or after their scheduled class. The Providers' duty of care concludes at the advertised finish time of each class, at which point responsibility immediately returns to the parent or guardian.


I acknowledge that I have been briefed on the risks involved, have carefully read and understood these Terms and Conditions, and voluntarily consent to participate in the Activities.



I certify that all information provided in this application is true and correct. I acknowledge that the Providers are entitled to rely upon the information supplied by me.

These Terms and Conditions may be amended from time to time. Written notice of any material changes will be provided.

By signing this application, you acknowledge that you have read or had the opportunity to read our Privacy Policy.

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Date
Day
Month
Year
PHYSICAL READINESS QUESTIONNAIRE

Note: Training may include, but is not limited to:

  • Stretching

  • Running

  • Punching and kicking

  • Striking shields and heavy bags

  • Physical contact with other participants

  • Sparring (non-contact and full-contact)

  • Strenuous and physically demanding exercise

Participants must complete the following questionnaire before commencing training.

Has your doctor ever said you have a heart condition or vascular disease?
yes
no
Do you ever experience chest pains?
yes
no
Have you experienced any chest pain recently?
yes
no
Do you ever feel faint, dizzy, lose balance or lose consciousness?
yes
no
Has your doctor ever said you have high blood pressure (140/90)?
yes
no
Are you taking medication for blood pressure or a heart condition?
yes
no
Are you a male over 35 or a female over 45 who is not accustomed to regular exercise?
yes
no
Do you have a bone or joint problem that could be made worse by increased physical activity?
yes
no
Do you suffer from asthma?
yes
no
Do you suffer from any other respiratory problems?
yes
no
Do you suffer from diabetes?
yes
no
Do you suffer from epilepsy?
yes
no
Do you currently suffer from any illness not mentioned above?
yes
no
Do you know of any other reason why you should not participate in physical activity?
yes
no

Note: If you answered Yes to any of the above questions, you may be required to provide a doctor's certificate or medical clearance before participating.

Do you suffer from any allergies?
yes
no

To the best of my knowledge, I have answered the above questions truthfully. I understand and agree that it is my responsibility to inform Macarthur Martial Arts Kyokushin in writing of any changes to my health or medical condition, now or in the future, which may affect my ability to participate safely in training.


I/WE AGREE TO THE ABOVE TERMS & CONDITIONS
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Date
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