Karate Registration Form

The below karate registration form is used to register your interest in the karate class. Please note the following:

Try to use a non-gmail account (if you have any). Google likes to filter out emails from fresh domains (like ours). Alternatively, add enquiry@keiseikan.org to your trusted contacts.

Keiseikan
Martial Arts

Name (include Chinese character name if any)

Date of Birth

Gender

Female Male

NRIC/FIN last 4 characters

Parent/Guardian name (if registrant below 18 years)

Parent/Guardian relationship

Phone number (WhatsApp compliant)

Address

Postal code

Medical condition

Emergency contact

Emergency contact number

Terms and Conditions

I accept the Terms and Conditions and the Privacy Policy.

Signature