Join Genesis Martial Arts Classes in Buckinghamshire & Oxfordshire

Parent/Guardian Name

First Last

Please complete this field if the student is under 18 years of age

Name

First Last

Date of Birth*

Gender*

Male
Female
Other

Gender

Instructor*

Address*

Address Line 1 Address Line 2 City Post Code

Phone*

Email*

Email 2

Emergency Contact Name*

Emergency contact relationship to student*

Emergency contact number*

Emergency Contact Name 2

Emergency contact relationship to student 2

Emergency contact number 2

Suit size*

The suit size plates to the height of the student. If you are unsure which size to choose, please measure the students height and pick the nearest.

Are you a new comer to exercise?*

Yes
No

Whilst every care will be given to the best of the instructor's ability, it is up to the individual to know their limitations.

If you have been inactive for many years we would strongly advise you to visit your Dr for a check up before joining any classes.

Do you have any health issues which Genesis instructors should be aware of before you commence training with us?*

Yes
No

Health issues

Please list details of any health issues that Genesis Instructors should be aware of which would affect your ability to train either online or in person. Please include any illnesses, injuries, allergies and or learning difficulties.

Join Genesis Martial Arts Classes

New Student Membership Form

Whilst every care will be given to the best of the instructor's ability, it is up to the individual to know their limitations.