Club Name *

Head Instructor First Name *

Head Instructor Last Name *

Phone *

Email *

I am the head instructor or an authorised representative of this club, and the details I have provided are true and correct.

The club agrees to train and grade to the Hapkido Australia national standard, uphold the Code of Conduct and Safeguarding Policy, and renew its affiliation each year. I consent to Hapkido Australia holding these details under the Privacy Act 1988 and listing the club publicly as an affiliated club.