Enrolment Form | Wing Tsun Academy

Enrolment

Step 1 of 4

Individual
Full Name*
Given Name Surname Preferred Name
Date of Birth

DD
MM
YYYY
Gender
Occupation

Contact Information
Email*
Cell Phone
Residential Address
Street Address Suburb City ZIP / Postal Code

Emergency Contact
Name
Given Surname Relationship
Best Contact Phone Number
Medical Information

Previous Martial Arts Experience
Please let us know if you have any previous martial arts experience or if you are currently practicing other styles. For Example: Name of style, how long you trained for, how long ago you trained, what rank you achieved (belt,sash etc), and the country/city you trained in.
WTA's terms*
I confirm that I understand and agree to WTA's terms. (the link to WTA's terms can be found below)
- I agree

Membership Terms

Direct Debit Form

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