Children & Teens programme4 Week Trial Enrolment for 10-14 year oldsPlease complete the form below to the best of your knowledge and expect a response within 2 working days. Please check your spam/junk folder for our return correspondence.WaiverAll Participants (or their adult legal Guardian if the Participant is under the age of 18) must complete the registration waiver before attending any classes. All information gathered herein is strictly confidential and will not be shared with anyone else.The Participant acknowledges that the training, programs and events (the “Activities”) held by Gyodokan West London Aikido may expose them to many inherent risks, including accidents, injury or illness.The Participant also acknowledges that the Activities may result in exposure to and contraction of COVID-19 or other communicable diseases passed on via other participants and use of shared space or equipment.Amidst the current developments surrounding communicable diseases, the Participant acknowledges that every time they participate in the Activities, they are affirming that they are healthy and that they do not present an increased risk due to infectious diseases.If the Participant tests positive or is diagnosed with COVID-19, they agree to immediately notify Aikido Gyodokan at aikidogyodokan@gmail.com.The Participant acknowledges and agrees that every time they participate in the Activities that they will follow Aikido Gyodokan's guidelines on etiquette and hygiene practices, and that they will act with responsibility towards others in order to ensure everyone’s safety.The Participant assumes all risk of injuries associated with participation in the Activities and practicing aikido including, but not limited to, falls, contact with other participants, exercises and techniques taught by Aikido Gyodokan's instructors and others and all other such risks being known and appreciated by them.The Participant acknowledges their responsibility in evaluating any physical and psychological concerns that might conflict with their participation in the Activities.The Participant acknowledges that they are physically fit and mentally capable of performing the physical activity they choose to participate in and that they have listed below all known medical history that Gyodokan West London Aikido should be aware of.The Participant agrees, for themselves and anyone entitled to act on their behalf, to hold harmless, waive and release Aikido Gyodokan and their respective officers, agents, employees, organisers, instructors, teachers, representatives, and successors (collectively the “Parties”) from any responsibility, liabilities, demands, or claims of any kind arising out of their participation in the Activities.By ticking this box, I have read, understand, and agree to the above. * *I am the parent or legal guardian of the participant, who is under the age of 18 and I agree.I, parent/guardian, give Aikido Gyodokan permission to use any still and/or moving image depicting my child in the practice of Aikido training for advertising, marketing, or any other use such as training, educational or publicity purposes. *YesNoParticipant's Full Name *Child's nameParent/guardian name (if participant is under 18) *Parent/guardian nameStreet Address *CityBoroughPostal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweParticipant's date of birth *Contact Number *Email Address *Emergency Contact Name *Emergency Contact Number *e.g. Next of kin. NOT phone number of participant.Training History *Health and fitness *Does your child have any special educational needs? *How did you hear about us?A responsible adult will be required to bring and collect your child from their trial classes (or they may stay to watch). Please name the adult/s responsible for doing so: *After your child's trial should you decide to join the programme, parents/ guardians can give permission for their children to leave class independently.4 week trial: £40 Total *Please pay using credit/ debit card.Consent *I acknowledge that payments to Aikido Gyodokan are non-refundable, except in exceptional circumstances and at Aikido Gyodokan's sole discretion.Yes, I agree with the privacy policy .Book and pay