Child Grading Form | Bayside Kyokushin Ka

Children's Grading Application Form

Grading applying for

Children's grading Saturday 15th Nov, 10.10am-12.00pm

Cannot make Saturday, will grade Tuesday 18th Nov, 4.15-5.50 pm

Name

Age on day of grading

Address

Phone

Number of Months Training

Current Kyu Grade

Emergency Contact Name

Emergency Contact Phone Number

I understand and do hereby swear that I will obey the rules of this grading and participate fairly. I accept responsibility for any damages, losses or injury that I may incur by participating in this grading. Whilst the Dojo operator takes care to ensure a safe grading, in the case of self-sustained injuries, the Dojo operator accepts no liability or responsibility; therefore as a participant I will at no time hold any of the instructors, owners or students liable for any claim of any nature.

This agreement is governed by the law of the state of Victoria.

I consent to images/videos with my child being used on Bayside Kyokushin Karate media platforms (Website/Instagram/Facebook). (Your consent can be withdrawn at any time, please speak with your instructor).

Grading fee is $120 per student

Payment

Bank Details

Name: Bayside Martial Arts Centre BSB: 033-095 Acct: 667633

PayID: 17 675 678 476

Parent or guardian name

Parent or guardian signature

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