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Consultation Form

This consultation form is to be filled by new students who wish to train with Galway Shotokan Karate Club. This is not a membership form.
All the information provided in this form will be used solely for the purpose of club training and will not be shared with other parties.

Student details
Contact details in case of emergency
Medical details
Student declaration
  1. I declare that the information I have given is correct and that as far as I am aware I can undertake training without any adverse effects. I do not suffer any contagious diseases (diarrhoea, vomiting etc) which could spread to other students in the Dojo and I am not under the influence or recreational drugs or alcohol.
  2. I acknowledge and understand that Shotokan Karate (and all associated training exercise) is a physical contact sport and carries with it potential for injury. I hereby agree to voluntary assume the risks of participating in Karate (and all associated training exercise) in consideration of becoming a member.
  3. I hereby declare that I am medically able to properly train and assume full and complete responsibility for any injury or accident that may occur while I am training in Karate or competing in tournaments.
  4. I am aware and assume all risks associated with training in Karate, including but not limited to falls, contact with other students, and condition of the premises being used. I for myself and my heirs and executors hereby waive, release and forever discharge the instructor of Irish Karate, sponsors, promoters and each of their agents, representatives of all my liabilities, claims actions or damages that I may have against them arising out of or in any way connected with my participation in Karate.