ENROLMENT INFORMATION

If you would like to become a member and join Combined Self Defence Tae Kwon-Do, Please see the procedure and form below for joining us.

FIRST MONTH
FREE
ENROLMENT & INSURANCE
FREE
Including the following FREE benefits

See below for monthly costs applicable after your free trial.

Training suit
Belt
Focus Pad
Web Site Access to student resources
Perpetual Licence & Insurance
First Grading (Including Belt and Certificate)
Unlimited training at any of our classes

Your training fee entitles you to unlimited training at any Tae Kwon-Do class in Carterton, Faringdon, Fairford, Chipping Norton or Stow on the Wold.
We train continuously throughout the year, including school holidays, with the exception of 5 weeks holiday. We do not provide training on bank holidays. Students can train at other lessons as top up.

MONTHLY TRAINING FEES
£50.00 Per Calendar Month (Discounted Price When Paid By Standing Order)

FAMILY MEMBERSHIP
Each additional family member will receive a discount off the regular membership fees when paying by standing order
1st Student = £50
2nd Student = £40 (total £90)
3rd Student = £30 (total £120)
4th Student = £FREE (total £120)

Please make all cheques payable to “L Chapman”.

******* PLEASE NOTE *******

IT IS THE STUDENTS/PARENTS RESPONSIBILITY TO ENSURE THAT ALL FEES ARE PAID ON THE 1ST OF EACH MONTH. LATE PAYMENT WILL INCUR A THE FULL PRICE OF £55, £100 OR £135

ALL MONTHLY TRAINING FEES ARE PAYABLE IN ADVANCE BY STANDING ORDER.
Membership is continuous, and there are no refunds for missed lessons. If you miss lessons, you are welcome to make up your training at alternative lessons/locations.

If you wish to cancel, please notify your instructor in writing giving a minimum of one months notice so they can make your place available to a new student.

You will be required to return the free training equipment and pad you were supplied. Finally you can then cancel your standing order. We cannot cancel your Standing Order. The instruction must come from you as you are the bank customer. By continuing to pay we will assume you have decided not to cancel and we will reserve your place in the class

Only equipment obtained through your instructor may be used within your Tae Kwon-Do School.
All equipment and training aids are to be obtained through your School Instructor.
THIS IS AN INSURANCE REQUIREMENT

Combined Self Defence Membership Application

Membership application form.

MEMBERSHIP APPLICATION FORM
Name*
Prefix First Last
Date of Birth*
DD slash MM slash YYYY
Address*
Street Address Address Line 2 City County Postcode
Email*
Phone*
Mobile*
Nationality*
Job/Occupation*

for children please type 'Student'
Your height (in CM's)*
(Required for uniform size)
T Shirt Size*
- Adult
- Junior
Adult sizes
- S
- M
- L
- XL
- XXL
Junior sizes
- 4-5
- 5-6
- 7-8
- 9-11
HOW DID YOU HEAR ABOUT C.S.D TAE KWON-DO SCHOOLS?*
HAVE YOU EVER BEEN CONVICTED OF A CRIME OF VIOLENCE?*
- No
- Yes
If YES please give details in the box below
Criminal convictions of violence
All information will be confidential and treated in accordance to European and UK data laws (GDPR).
WHAT DO YOU HOPE TO ACHIEVE FROM TRAINING IN TAE KWON-DO?*
Hidden
Student Photograph
Please upload a photograph of the applicant.
Hidden
Student photograph
Accepted file types: jpg, jpeg, Max. file size: 64 MB.
Q. Why do we need a photo? A. Your photograph will be printed onto your personal training/grading record card.
EMERGENCY CONTACT DETAILS (This section MUST be completed in full)
Contact 1
Name*
First Last
Home Phone*
Mobile Phone*
Relationship*
Contact 2
Name*
First Last
Home Phone*
Mobile Phone*
Relationship*
Privacy Policy
This privacy policy sets out how we use and protect any information that you give to us when you become a member of Combined Self Defence. We are committed to ensuring that your privacy is protected, and we will never release your personal details to any third party without your express consent. When you complete an application to join a Combined Self Defence club, certain personal information is collected from you. You can be assured that it will only be used in accordance with this privacy policy. What information we will collect: Forename and Surname Date of Birth Photograph Current Address Contact telephone numbers Contact email Gender Medical Conditions Next of Kin name and emergency contact details. Why we need the information we gather We require this information to administer your membership and to provide the products and services you have requested from us and provide you with an efficient service for the following reasons: Internal record keeping, recording financial transaction to your membership fee account Sending membership fee notices to you, contacting you with relevant club correspondence Maintaining a record of your grade status and related grading examinations Sharing personal details for membership and insurance purposes only. Taking photographs of students for: Including but not limited to LOCAL PRESS ARTICLES, PROMOTIONAL LITERATURE OR FOR TRAINING LITERATURE, INCLUDING WEB SITE PHOTOS. Combined Self Defence will retain your personal information on our membership database for the duration of your membership, and for a period of 12 months after your membership has expired. We take your privacy seriously and all such information is held securely. Combined Self Defence complies with all applicable Data Protection Regulations. We may change and update this policy from time to time and will notify you accordingly.
Physical Activity Readiness Questionnaire
Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming physically active. The questions below will indicate if you should check with your doctor before you start. If you are over 69 years of age and you are not used to being very active, you should check with your doctor. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: Please tick YES or NO. If the answer to any of these questions is YES, we require a Doctors note or a letter from the student/ parent giving relevant details of the problem and training limitations along with a statement that the student is fit enough to train in Tae Kwon-Do. (If you need to make corrections, please ask for a new form)
Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming physically active. The questions below will indicate if you should check with your doctor before you start. If you are over 69 years of age and you are not used to being very active, you should check with your doctor. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly: Please tick YES or NO. If the answer to any of these questions is YES, we require a Doctors note or a letter from the student/ parent giving relevant details of the problem and training limitations along with a statement that the student is fit enough to train in Tae Kwon-Do. (If you need to make corrections, please ask for a new form)
Questions:
Has your doctor ever said that you have a heart problem?*
- Yes
- No
Has your doctor ever suggested you restrict your physical activity?*
- Yes
- No
Do you have high blood pressure?*
- Yes
- No
If you have undertaken physical activities in the past did you feel pain in your chest?*
- Yes
- No
In the past, have you had chest pains when you were not doing physical activity?*
- Yes
- No
Do you suffer from dizziness?*
- Yes
- No
Do you suffer from loss of consciousness or fainting?*
- Yes
- No
Do you have a bone or joint problem aggravated by physical activity?*
- Yes
- No
Is your doctor currently prescribing medication for you?*
- Yes
- No
Do you suffer from Hay Fever?*
- Yes
- No
Do you suffer from Asthma?*
- Yes
- No
Do you suffer from Migraine?*
- Yes
- No
Do you suffer from Epilepsy?*
- Yes
- No
Do you suffer from Diabetes?*
- Yes
- No
Do you suffer from a Nervous Disorder?*
- Yes
- No
Do you suffer from Haemophilia?*
- Yes
- No
Do you know of any reason why you should not do physical activity?*
- Yes
- No
Declaration
I understand that there is an inherent risk of physical injury in the practice and learning of a contact sport such as Martial Arts. Whilst Combined Self Defence and Instructors will take all reasonable steps to minimise the likelihood of an accident, the risk of physical injury cannot be eliminated. There is particular risk in the context of competitions and grading exercises, which by their nature are likely to result in an individual approaching and potentially exceeding the limits of their skills and physical ability. The acceptance of an individual’s application to participate in a competition or to undertake a grading exercise does not constitute and should not be considered as constituting any form of confirmation or assurance by Combined Self Defence or its Instructors to the affect that the individual has the necessary skill or physical ability to safely complete such competition or grading exercise, it being the individual’s sole responsibility to judge such matters for themselves. If an individual has any doubt whatsoever as to their ability to safely complete any exercise in the context of a competition, grading exercise or otherwise it is the responsibility of the individual to withdraw from the same. Combined Self Defence or its Instructors accept no liability for injuries sustained in the course of practicing and learning of Martial Arts, save for injuries attributed to negligence of Combined Self Defence Instructors. Insurance in respect of such risks is included in your annual membership. In signing this declaration I accept the above recited disclaimer of liability and also agree to abide by the rules of Combined Self Defence as amended from time to time should I be accepted as a member. This information is true to the best of my knowledge and I understand that any information incorrectly supplied may lead to the revocation of my Combined Self Defence Martial Arts Licence Membership is continuous. Late payments will exclude you from the Standing Order discount that is included in your fees. There are no refunds given for missed lessons. Any lessons you miss can be made up at alternative lessons/locations. If you wish to cancel, please notify your instructor in writing giving a minimum of one months notice so they can make your place available to a new student. PLEASE NOTE: You are required to return the equipment that was provided to you on sign up (Trousers, Tee Shirt, Focus Pad & Bag) failure to do so will attract a fee of £60 to cover the replacement of such. You are responsible for cancelling your own standing order as the bank will only accept their own customer’s instruction. I have read, understood and agree to the above purposes for Combined Self Defence to use my data.
Acceptance*
- I have read, understood and agree to the above purposes for Combined Self Defence to use my data.
TAE KWON-DO LICENCE & PERSONAL ACCIDENT INSURANCE
Whilst injuries in Tae Kwon-Do are not quite common place as in other contact sports these can at times, be so serious as to dramatically affect the injured party or even result in death. The natural reaction in such cases is to seek compensation and this will involve court action which may or may not be successful. It is estimated that only one in five such actions results in an award of damages and a seven or eight year delay must be anticipated. Personal accident insurance will provide such automatic compensation without the need to prove that anybody is liable. To provide immediate compensation without need to prove liability or pursue court action Combined Self Defence have arranged Personal Accident Insurance in respect of all members. This should ensure that in the event of death a sum is available to the member’s direct dependents but where permanent total disablement, such as loss of an eye, a limb, or total inability to pursue an occupation occurs, higher compensation to help rebuild a shattered life is called for. Whilst no amount of compensation can adequately replace the quality of living previously enjoyed, a sensible benefit of around £25,000 is considered suitable. Weekly benefits to assist, but not to replace for the loss of wages is also insured through this particular benefit only applies to people in waged employment. The insurer considers this fact relative to the ages and employment conditions of their membership and to this end a small degree of assistance is given to students and junior members. The benefits are as follows; Death: £5,000 per Insured Person of under 18 years of age, £25,000 per Insured Person over 18 years of age Total and Irrecoverable loss of sight in one or both eyes: £25,000 Loss of one or two limbs: £25,000 Total and Irrecoverable loss of sight of one eye and loss of one limb: £25,000 Permanent Total Disablement: £25,000 Total loss of sight of one or both eyes or loss of limb: £25,000 Temporary Total Disablement: £5 per week per Insured Person under 16 years of age. Entitlement To this benefit is to a maximum sum of £250 £60 per week per Insured Person over 16 years of age in full / part time employment. Entitlement to this benefit is dependent upon loss of earnings incurred to a maximum of £60 per week. Maximum sum payable £3,000 £15 per week per Insured Person who is unemployed and students in full time education. Entitlement to this benefit is dependent upon loss of any other benefit / grants due to the injury to a maximum of £15 per week. Maximum sum payable £300 To qualify for any of these benefits you must have been absent from employment or studies for a period of more than two weeks and proof of absence and loss of earnings will need to be supported by official paperwork i.e. Medical Certificates In order for any of the above benefits to be applied, claims should be submitted in writing to the Combined Self Defence Insurance Officer within 21 days, failure to do so will jeopardise your claim and may result in loss of benefits. Liability Insurance Injury to a third party or damage to property of others could almost automatically result in a claim for damages, such claims and their associated expenses should the case go to court can be very costly. In the absence of adequate Liability Insurance, members will find themselves financially responsible for any damages and costs awarded, to this end included in the membership insurance is a Third Party Liability Insurance for all its members. Benefit is as follows; Limit of Liability £5,000,000 / unlimited in any one of insurance All insurance cover is only available to British Nationals and students who have resided in the U.K. for longer than six months.
COMBINED SELF DEFENCE CHILD PROTECTION POLICY STATEMENT
It is the policy of Combined Self Defence to safeguard the welfare of children and all others involved in its activities by protecting them from physical, sexual and emotional harm. If you suspect a child is being abused: 1. Initially inform your Instructor or School Owner. 2. Record the facts as you know them and give a copy to the relevant Safeguarding Lead. 3. Ensure that the child has access to an independent adult. 4. Ensure that no Tae Kwon-Do situation arises which could cause any further concern. If a child discloses to you abuse by someone else: 1. Allow the child to speak without interruption, accepting what is said. 2. Alleviate feelings of guilt and isolation, without making any judgement. 3. Advise that you will try to offer support, but that you must pass the information on (steps 1-4 above) the same way as in suspecting a child is being abused. If you receive an allegation about any adult or about yourself: 1. Immediately inform a member of your organisation’s Safeguarding Team. 2. Record the facts as you know them and forward a copy to your organisation’s Safeguarding Team. 3. Try to ensure no one is placed in a position, which could cause further compromise. THE INSTRUCTOR MUST REFER; THEY MUST NOT INVESTIGATE
Declaration
Hidden
Please read the information below
I confirm the student is free from any symptoms related to the COVID-19 virus, I understand the main symptoms include: • a high temperature – this means you feel hot to touch on your chest or back • a new, continuous cough – this means coughing a lot for more than an hour, or three or more coughing episodes in 24 hours • a loss or change to your sense of smell or taste.

I am also confirming all in my household remain symptom free, and anyone taking me to or from training and attending my training session with me is also symptom free from the virus. I confirm that for any future training sessions I will only attend in the full knowledge that I am free from any COVID-19 symptoms. In addition, but conversely confirm by signing this declaration that if I do display any symptoms I will not attend training for the required government isolation period, contact Lee Chapman and follow government guidance to self-isolate.

I will return to training knowing that my participation cannot be without risk, I am therefore aware of these risks associated with the COVID-19 virus, but still wish to participate in training.

I understand the processes and protocols that have been put in place in order to reduce risks and I will adhere to these in order to protect my health and the health of other members, staff and other users of the facility.

By signing this form I am confirming that I have read the above information, understand and agree to the conditions laid out. Please note: membership will not be accepted unless this form is signed and returned and confirmed as being read on the licence application form.
Students' Name*
First Last
Your Signature*
To be signed by the person completing the form
Role of signatory*
- Parent
- Guardian
- Member/Applicant
Date*

Day
Month
Year
Comments
This field is for validation purposes and should be left unchanged.

Save and Continue Later

ENROLMENT INFORMATION

FIRST MONTH FREE ENROLMENT & INSURANCE FREE Including the following FREE benefits

Only equipment obtained through your instructor may be used within your Tae Kwon-Do School. All equipment and training aids are to be obtained through your School Instructor. THIS IS AN INSURANCE REQUIREMENT

Combined Self Defence Membership Application

MEMBERSHIP APPLICATION FORM

Student Photograph

EMERGENCY CONTACT DETAILS (This section MUST be completed in full)

Contact 1

Contact 2

Privacy Policy

Physical Activity Readiness Questionnaire

Questions:

Declaration

TAE KWON-DO LICENCE & PERSONAL ACCIDENT INSURANCE

COMBINED SELF DEFENCE CHILD PROTECTION POLICY STATEMENT

Declaration

Please read the information below

FIRST MONTH
FREE
ENROLMENT & INSURANCE
FREE
Including the following FREE benefits

Only equipment obtained through your instructor may be used within your Tae Kwon-Do School.
All equipment and training aids are to be obtained through your School Instructor.
THIS IS AN INSURANCE REQUIREMENT