Online registration

Secure form

Kyu Shin Kan Omeikai Membership Application

Complete the form below to join Kyu Shin Kan Omeikai. The page is designed to work comfortably on mobile, tablet and desktop.

Before you begin

Having these details ready will make the application quick and straightforward.

  • Your preferred membership status and dojo
  • Personal contact details and postal address
  • An emergency contact with relationship and phone number

Helpful notes

Junior applications will automatically relabel the contact sections for a parent or guardian.

Required fields are checked before the form submits so you can correct anything quickly.

Application snapshot

Typical time
About 2–5 minutes
What you need
Contact details and emergency contact
Final step
Confirm the privacy consent before submitting
Application form

Tell us about your membership

Work through each section below. Your information is grouped clearly to keep the form easy to scan and complete.

4 sections plus consent
Membership information

Choose the membership status and dojo where you train.

Please choose an application status.
Please select the dojo where you train.
Please choose an instructor from the list.
About you

Add the applicant's personal, address and contact information.

Valid first name is required.
Valid last name is required.
Please enter a valid email address for membership updates.
Use the date picker to enter the applicant's date of birth. Adult and concession memberships are available from age 18.
Junior applicants must be at least 5 years old and under 18.
Please enter your mobile in an international format e.g. +441234567890
Please choose a gender option.
Please enter your address.
Please enter your city.
Please enter your county.
Please select a valid country.
Post code required.
Emergency contact

Provide the person we should contact if there is an emergency.

Please add the emergency contact's first name.
Please add the emergency contact's last name.
Valid number is required.
Please choose the relationship to the applicant.
Grade history

(Optional) Share your training history.

Please enter the year you started with Kyu Shin Kan Omeikai.
Please enter the date of your last grade.
Please enter the organisation of your last grade.

Fields marked with an asterisk are required before you submit.