Signup

I {name} confirm that the details provided for my membership are to the best of my knowledge correct at the time of signing I {name}, born {dob}, of {address} Confirm that to the best of my knowledge I have upon registering membership with Wing Chun international disclosed to the senior Instructor ( Sifu Simon Lazarus) or authorised team member all previous or existing injuries, illnesses and conditions both Physiological (physical) and Psychological (mental) and any medications, pharmaceutical drugs or other substances legal or otherwise being used by myself  which may affect my ability to train safely within a classroom or private lesson setting with an instructor, fellow student or official visitor.I {name}, born {dob} of {address} confirm I understand I train entirely at my own risk and that any pre-existing injuries, illnesses, conditions and any injuries to myself or others however serious caused directly or indirectly as a result of my pre existing conditions are my own responsibility. I {name}, born {dob} of {address} confirm I understand that any injuries to myself or others caused directly or indirectly as a result of my actions or lack thereof, other than in strict observation of instructions given by WCI Instructor remain my responsibility.I {name}, born {dob} of {address} also confirm that to the best of my knowledge I have disclosed any criminal  convictions or current police investigations involving myself which may affect my suitability to train in a classroom environment with persons aged under the age of 18.I confirm that I understand that although WCI Swindon endeavour to be inclusive right is reserved to refuse instruction.  If I knowingly provide false information or omit information Instruction may be refused. If I wilfully disregard instructions given by an instructor or if I wilfully assault an instructor or fellow student outside the context of instruction being given, WCI reserve the right to dismiss me from the training venue and refuse any future instruction without refund of monies paid.Signed: {sign_date} Initials of Signatory (Member O'18): Initials of Signatory if signing on behalf of a person under 18