Application Form

: :

TAI CHI UK & ZENON WUDANG TAI CHI CHUAN ENROLMENT FORM

Please fill in as much detail as you can:

Benefits for Members:

Free Tai Chi UK T-Shirt

Reductions in seminar/courses & regular classes run by Tai Chi UK.

10% reductions off all purchases.

Free update on all new developments and holidays organised by Tai Chi UK.

Free advertaisement of member's services on the Tai Chi UK Web Site.

Annual membership Fee Ł60.00

Annual Membership for Students & Unemployed Ł30.00

Please fill in as much detail as you can:

Surname: First name:

E-mail: Gender: Male Female

Address:

Tel No: Option:

Date of birth: Age: Profession:

Have you got any ailments/disabilities we need to know about?

Are you interested in the Instructor's course?: Yes No

Please enter a venue(if known) and date you intend joining:

Are you interested in teaching abroad?: Yes No

Do you practice a form of Martial Arts?: Yes No
If so, please state which style:

Name & address of person to contact in case of emergency:

Relationship:

It is a legal requirement that participants of any form of martial art hold a current licence to practice. Please read the statement below and sign your name as an indication that you have understood it and you accept it.

I, accept that I have to obtain a British Council for Chinese Martial Arts (BCCMA) insurance licence to cover me for any injuries I might incur or accidentally inflict on others during training. I understand that if I incur any such injury or inflict any such injury on anyone, having failed to obtain the insurance, I will not hold any of my instructors liable. The BCCMA licence fee is included in your registration fee.

Please select as appropriate.

Relaxation Programme (12 session course)
I will make payment for the registration fee of Ł50.
I will make full payment for the course, which is Ł200

Zenon Wudang Sash Grading
I will make payment for the registration fee of Ł20.
I will make payment for the Sash exam of .
The month I wish to be examined in is:
Venue will be arranged by the course instructor.

Club Membership
I will make payment for membership to Tai Chi UK for the sum of Ł30/Ł60 (per annum)

Method of payment:
Check (acc no. required)
PO/IMO (order no. required)
Cash by advice only

How to make payments.

Cash payments contact for advice. taichiuk@taichiuk.co.uk

Uniforms, video and books are also available.

Enquiries:- Tel/Fax: 0207 407 4775. Mobile: 0956 913 437