JP BUYS Martial arts academyMEMBERSHIP APPLICATION FORMComplete the form below to join the Empire. Full Name * First Name Last Name Email * Phone Number of Emergency Contact * (###) ### #### Date of Birth * MM DD YYYY Address Address 1 Address 2 City State/Province Zip/Postal Code Country Gender * Male Female Medical History: Do you have any pre-existing medical conditions? * Name of Emergency Contact * First Name Last Name Phone (###) ### #### Select Membership Type * Adult (All Access): R1000 Youth (All Access): R1000 One-On-One (excl. session fee): R500 I have read and accepted the Terms and Conditions * https://www.jpbuys.com/terms I accept I hereby apply to become a member of The JPB Martial Arts Academy and agree to the full terms and conditions, and accept the medical risks and disclaimer. Type your full name to confirm acceptance * I acknowledge that my membership is active on receipt of payment. Monthly membership fees are due in advance (1st day of the month of training) I accept Welcome to the JP Buys Martial Arts Academy.A payment link will be shared on email (Payfast generated) to complete your application process. Please complete the payment to activate your membership.We look forward to growing together in strength and skill. For Loyalty. For Legacy. For the Empire.