Registration Form

Please highlight all text below – copy it – then paste it into a word document and then print this form, complete it and hand it to Sensei Greg Mayo when you come for your first visit.

(I apologise for the inconveniance)

Ellerslie Aikido Registration Form:

Participants Name (s):________________________________________________

Current Age:______________________________ Date of Birth:______________

Parents Name:               _______________________________________________

Address:                          _______________________________________________

Contact Details:             _______________________________________________

Email Address:               _______________________________________________

Emergency contact:      _______________________________________________

Any health conditions you would like to inform us of?

__________________________________________________________________

__________________________________________________________________

How did you hear about us?

__________________________________________________________________

Please bring a water bottle, clean hands& feet and a smile to Aikido training.

Aikido is a martial art involving holds, pins and throws; we participate in

partner practice involving grasping and striking attacks.

Your teachers will exercise care so as to avoid injuries but we are unable to guarantee against injury.

Please assist us by following your teacher’s instructions.

Please exercise care for yourselves and show respect for your training partners at all times.

Thank you:

Club bank account for AP’s-          Kiwi Bank

Branch: Mt Wellington

Acc No: 38-9008-0242371-00