GAMMA Register Form

ATHELETE APPLICATION FORM

Student Details - Step 1 of 2

Name *

First

Last

Gender *

• Male
• Female

Date of Birth *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920

Age *

Contact Number *

Email *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Emergency and medical information (In case) *

Emergency Contact Number 1 *

Emergency Contact Number 2 *

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Education/ Work/ Martial arts Background *

Grade/ Position/ Level *

Year *

Venue *SelectFly River Haus

Select Batch *SelectBatch One (Monday, Wednesday & Friday)Batch Two (Tuesday, Thursday & Saturday)

Session Fee *

• K250 per month
• K25 per session

Do You Suffer from any Medical Conditions? *

• Yes
• No

If Yes

Supporting Documents

Click or drag a file to this area to upload.

Declaration *

• I, hereby declare the information that i have provided on this form is complete and accurate. On admission into the course, I hereby undertake to abide by the World Taekwondo Federation and GAMMA rules and regulations.

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Submit