Karate License Request Form

Applicant's Personal Details

Please provide the personal details of the person who will be attending karate classes (the applicant).

Application Type *

Adult £50

For applicants aged 18 and over at the time of application.

Junior £45

For applicants under 18 years of age at the time of application.

License Type *

First Time License

For new members who have never had a Shukokai Karate license before.

License Renewal

For existing or returning members who have previously held a Shukokai Karate license.

First Name *

Last Name *

Contact Number *

Email *

Address *

Date of Birth *

Gender *

Male Female Prefer not to say

Accessibility & Medical Information

I have accessibility needs or medical conditions that the instructors should be aware of

Why we ask: Under the Equality Act 2010, we are committed to making reasonable adjustments to ensure everyone can participate in our activities. This information helps us provide appropriate accommodations for your karate training.

Data privacy: Any medical or accessibility information you provide will be treated confidentially and only shared with instructors who need to know to ensure your safety and appropriate participation.

What to include: Please only share information relevant to your karate practice, such as mobility limitations, medical conditions that might affect training, or accommodations that would help you participate fully.

License Details

Your license will be registered with Kimura Shukokai Karate under the Shukokai Karate Federation (SKF).

Current License Number (if known)

If you don't know your license number, don't worry. We'll attempt to look it up for you when processing your application.

Current License Expiry

Current Grade *

Responsible Parent/Guardian Details

Please provide your contact details as the responsible parent or guardian. These will be our main point of contact for all matters related to the junior's training and membership.

Email *

Contact Number *

As the responsible parent/guardian, you will be our primary contact for all communications regarding the junior's training, events, and membership. Please ensure the contact details provided are regularly monitored.

Acknowledgements

I confirm that all information is correct and that all relevant existing license information is accurate * I will comply with all necessary safeguarding & code of conduct policies, which can be found at our safeguarding page. I understand that serious breaches of these policies could result in immediate removal from future lessons and training. * I understand that my information will only be processed in the UK & EU in compliance with GDPR. I agree with the privacy policy and understand that my data will be shared with Shukokai Karate Federation (SKF) who are the issuers of the license. *