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Kickboxing with Genesis Martial Arts
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Kickboxing Junior/Adult Main Grading
June 29
Applicant/parents details
Applicants/Parents Name
*
First
Last
Grading Details
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Date
*
29th June 2025
Date
*
29th June 2025
Venue
*
Judo Centre, Barry Close, High Wycombe, HP12 4UE
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Venue
*
Stoke Poges Village Centre
Students details
Student's Name
*
First
Last
Does the student have any conditions, illnesses, or injuries that could affect their performance in the grading?
*
No
Yes
Please add details
Date of birth
*
DD slash MM slash YYYY
Which belt are you grading for?
*
Please select
White Belt
Blue Belt
Orange Belt
Green Belt
Purple Belt
Brown Belt
Brown Belt White Stripe
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Which sash are you grading for?
*
White Sash
Blue Sash
Orange Sash
Green Sash
Yellow Sash
Purple Sash
Brown Sash
Time
*
Arrive by 09:00am. Start time 09:15am - 09:45am
Time
*
Arrive by 10.30am. Start time 11:00am - 12:00 Noon
Time
*
Arrive by 9:30am. Start time 10:00am - 10:45am
Time
*
Arrive by 11:45am. Start Time 12:15am - 1:30pm.
Time
*
Arrive by 1:00pm. Start Time 1:30pm - 3:15pm.
Belt Size
*
Please select
250cm (up to 26" waist)
280cm (up to 32" waist)
320cm (32" waist and above)
Student Category
*
Please select
Junior
Teenager
Adult
Instructor Name
*
Please select
Corey Cain
Fitzroy Connor
Jett Westwood
Joel Hoyte
Matthew Jackson
Trevor John
Licence No:
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I have been pre-approved for this grading by a Genesis Instructor
*
Yes
No
Please make sure you have 3 belt tags from your instructor (excluding those taking white belt) If you do not have 3 tags – do not continue – you might not be eligible to grade!
Please do not continue – speak to your instructor as you must be pre-approved before applying for your next grade
Contact Details
Address
*
Address Line 1
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City
Post Code
Emergency contact number
*
Email
*
Payment Details
White Belt
*
Price:
Blue Belt
*
Price:
Orange Belt
*
Price:
Green Belt
*
Price:
Purple Belt
*
Price:
Brown Belt
*
Price:
Brown Stripe
*
Price:
Blue Sash
*
Price:
Orange Sash
*
Price:
Green Sash
*
Price:
Yellow Sash
*
Price:
Purple Sash
*
Price:
Brown Sash
*
Price:
Total
£ 0.00
Pay online
*
Card Details
Cardholder Name
Δ
Details
Date:
June 29
Website:
https://www.genesis-ma.com/book-grading/
Organiser
Genesis Martial Arts
Email
enquiries@genesis-ma.com
View Organiser Website
Venue
Wycombe Judo Centre
Barry Close
High Wycombe
,
Bucks
HP12 4UE
United Kingdom
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Details
Date:
June 29
Website:
https://www.genesis-ma.com/book-grading/
Organiser
Genesis Martial Arts
Email
enquiries@genesis-ma.com
View Organiser Website
Venue
Wycombe Judo Centre
Barry Close
High Wycombe
,
Bucks
HP12 4UE
United Kingdom
+ Google Map
Second Dan Black Belt Course 2
Brown and Black Belt Tag Course 2
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