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Mt Roskill Joining Form
Please don’t complete this form until you have completed a
Free Trial
Please enter information about the person joining below
First Name
Last Name
Gender
Male
Female
Address
Postcode
Home Phone
Mobile Phone
Email
Age
DoB
Occupation
Medical Issues?
For Under 18s: Parent / Guardian information
Parent/Guardian Name
Contact Phone
Email
Occupation
Class Details
Please select which class you will attend
3.30pm Mini-Kids Class
4.30pm Colour Belt Class
First Lesson date
This will be the date of your first Direct Debit payment
Initial Payment
This page is to set up your initial payment to us. We will invoice you or you can pay using Eftpos at our Warrior TKD office.
Joining Fee
Joining Fee already Paid
Individual Registration ($95)
Family Registration ($150)
Dobok
No Uniform thanks
Beginner Uniform ($85)
Matrix Uniform ($95)
Dobok Size
Other Amount
Initial payment to do on-line
Yes, please invoice me and I will pay on-line.
Initial payment to do in office
I will pop in and pay using Eftpos at your office (198 Marua Road, Ellerslie, Mon-Thu between 4.30 and 6.30pm).
Your Monthly Fee Payments
Your regular training fees are paid month to month by Direct Debit. This section gives us your authority to set that up for you.
Bank
Account Name
Account Number
Direct Debit Fees Acceptance
I/We authorise you until further notice to debit my/our account with all amounts which Ezi debit (NZ) Ltd the registered initiator of the above Authorisation Code, may initiate by Direct Debit. I/We acknowledge and accept that the bank accepts this authority only upon the conditions listed in the following section.
I Accept the Direct Debit fees: Administration (once only): $2.30 Transaction fee: $1.36 Dishonour Fee: $21.90
Our Taekwon-Do club is affiliated to International Taekwon-Do (ITKD). Registration with this governing body is compulsory for all clubs nationwide, and is included in the joining fee. There is also an annual re-registration fee, but this is included in your monthly training fees so we pay this for you.
Terms and Conditions
Warrior Terms
I have read and accept the
Warrior TKD Club Terms & Conditions
.
Payment Authorisation
For purposes of this payment authorisation, the term “I” refers to the bank account holder of the bank account number above, and who’s signature accompanies the bank account number. I authorise you to pay for the Taekwon-Do membership on my behalf to Paul M Ltd trading as Warrior Taekwon-Do in the amount given below beginning at the date specified. These payments will continue until I submit a written notice of cancellation of my membership with 30 days notice. I agreed I am bound by the membership and payment terms and unpaid account balance due upon cancellation. I agree that you will be fully protected in honouring these direct debits and that your treatment of them and rights in respect of them are the same as if personally signed by me. I understand that I must notify Warrior Taekwon-Do of account changes.
Direct Debit Terms & Conditions
I have read and accept the
Direct Debit Terms & Conditions
.
How did you hear about us?
Word of mouth
Internet Search
Warrior TKD Website
ITKD Website (itkd.co.nz)
Social Media
Other
Submit
Main Menu
About Us
Our Club
Our Organisation
Our Team
Why Taekwon-Do?
For Whom?
Classes
Kubz
Mini-Kids
Colour Belts
Family Class
How to Join
Tuition Fees
Taekwon-Do Free Trial
Join
Members
News
Calendar
Photos
Resources
Instructors Only
Contact
Phone 09 580 0411