Dragon Membership

Registration Form

Complete your training details, emergency contact, goals, waiver, and signature before your first session.

Dragon Membership

Registration Form

Applicant details

Date *

Driver licence #Name *Surname *

Date of birth *

Mobile *Business phoneEmail *Occupation

Address

Address *Street addressCityStatePostcode

Country

Emergency contact

Emergency contact name *Emergency contact mobile *Relationship *

Training interests

BoxingBoxing CircuitKickboxingMuay ThaiKids ClassesPersonal TrainingLeg WorkoutAbClassBack CareWeight LossPre/Post NatalBody SculpturingCompetitionBJJMMAOther Training Interest

Option chosenTraining sessions per week *

Medical and goals

Do you have any injuries or medical conditions?

NoneYes

If yes, please verifyWhat results would you like to achieve from your training? *How soon do you want to achieve this? *

Free pass referrals

Optional

1. Name1. Mobile

Waiver and signature

I acknowledge that participation in any martial art or training programs is a potentially dangerous activity. I acknowledge that at all times whilst on the premises, both myself and my personal belongings shall be at my own risk and I now release and not hold Dragon Health & Fitness or its instructors liable for any personal injury, ailment, loss of property or life, whether caused by negligence of the Centre, its agents, members or by use of training equipment or facilities. I acknowledge that all financial arrangements must be finalized prior to training. I warrant that I am physically and medically sound to proceed with a normal course of exercise. Membership not transferable. 12 months minimum. No refunds.

Signature of applicant or guardian *