Membership Enrollment Form 2024 Memberships Enrollment FormStudent DetailsName(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Date of Birth MM slash DD slash YYYY MOB Gender Male Female Email MEDICAL INFORMATION / INJURIES & MEDICAL CONDITIONANY SPECIAL LEARNING REQUIREMENTS OR DIFFICULTIESParents DetailsMother's Name(Required) First Last Phone Number(Required)Father's Name(Required) First Last Phone Number(Required)TUITION FEES: THE UNDERSIGNED AGREES TO PAY training fee of $89.99 + $2.30 admin fee per fortnight. I acknowledge that I am entering into a 12 months membership agreement. Training fee are divided in equal payments for the purpose of budgetingEmergency ContactName(Required) First Last Relationship Phone Number(Required)I, THE UNDERSIGNED, do hereby apply for membership to White Wolf Martial Arts, and certify that all information supplied by me is correct. I UNDERSTAND that this membership does not include the Competition Squad Training Classes. I UNDERSTAND that my tuition is arranged to be made in fortnightly installments or set term payments in advance and is not affected by my lesson schedule and/or attendance. Tuition fees will be debited from my account or credit card each fortnight. Training Fees are nonrefundable. I UNDERSTAND that if any insufficient fund direct debit in my account will incurs $15 surcharge per transaction I UNDERSTAND that unless I provide written notice of termination of my membership prior to the end of the minimum period of my periodic billing membership agreement, my membership fees will continue to be deducted until 30 days after I provide written notice after the agreed term. I am required to give one-month notice of cancellation by completing the appropriate cancellation form. Cancellation will not be accepted by phone or by mail unless on the prescribed form. I UNDERSTAND that paid in full tuition payments can be held in credit but not refunded. I UNDERSTAND that White Wolf Martial Arts will be closed during the school holidays period for 1 week, each Term Break. White Wolf Martial Arts will also be closed during the Christmas and New Year holidays break for approximately two and half weeks. I UNDERSTAND that membership can be suspended for a minimum of four weeks with four weeks advance notice by completing an appropriate membership suspension form. Membership cannot be suspended during the club closure days as stated above.. I UNDERSTAND that training fees are calculated and paid over a twelve months period including all club closures/public holidays. I UNDERSTAND that the cancellation policy is a twenty percent discount of the remaining agreement amount owing to be paid out. I UNDERSTAND that any payments shall be made whether or not I use the facilities at White Wolf Martial Arts. I UNDERSTAND that a failure to complete training does not relieve me of my obligation to pay the fortnight tuition in full. I UNDERSTAND and agree that the school will not be held liable for injuries, damages etc., not caused by or resulting from the negligence of the owners, operators, employees or persons in charge of the establishment. I UNDERSTAND that under the terms of this agreement, the school obligates itself to furnish me with competent instruction and suitable facilities for teaching lessons. All class sessions are supervised by personnel trained in the procedures and traditions of the martial arts. THE STUDENT hereby represents that he/she is physically fit to receive and participate in the prescribed course of instruction. THE STUDENT understands that Martial Arts area contact sport and assumes the risk of and responsibility for any injury, death or property damage resulting from their participation in the activity. I WILL conduct myself with appropriate behavior as befitting the values of White Wolf Martial Arts, and will faithfully comply with all the rules and regulations of the school and the traditions of the martial arts. I UNDERSTAND White Wolf Martial Arts regularly takes photographs/videos and reproduces photographs and videos, of patrons on White Wolf Martial Arts property or at a White Wolf Martial Arts organized event for use in its publications, promotional and marketing material, on its website and in advertising both internally and externally, to promote White Wolf Martial Arts. I understand that by signing these terms and conditions I give White Wolf Martial Arts, who is either employed or commissioned by White Wolf Martial Arts, to make and use my/my child’s picture and authorize the use and reproduction of it by White Wolf Martial Arts, or any authorized by White Wolf Martial Arts management. This includes any and all photographs and videos which the aforementioned have this day taken of me, for any purpose whatsoever, without compensation to me. I understand and agree that all/or any negatives and positives, together with the prints shall be and remain the sole property of White Wolf Martial Arts. I ACKNOWLEDGE that whilst at White Wolf Martial Arts, both my property and my person shall be at my own risk, and I will not hold White Wolf Martial Arts or its staff, directors or volunteers liable for any personal injury or loss of property arising whilst on these premises. I have read and understood the above and agree to all terms and conditions of the agreement. I ACKNOWLEDGE receiving a copy of this agreement. SignatureParent/Guardian if under 18yo Date of Joining Full Name of Parent/ Guardian(Required) First Last