* = Required Field

*First Name

*Surname

*Phone

(numbers only please)

*Email

*Sex

Choose one... Female Male

*Rank

Choose one... White/Yellow I (9th Gup) Yellow II (8th Gup) Yellow III (7th Gup) Blue I (6th Gup) Blue II (5th Gup) Blue III (4th Gup) Red I (3rd Gup) Red II (2nd Gup) Red III (1st Gup) Cho Dan Bo 1st Dan 2nd Dan 3rd Dan 4th Dan 5th Dan 6th Dan 7th Dan 8th Dan 9th Dan

*Date of Birth:

Date:

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Month:

Choose... January February March April May June July August September October November December

Year:

Choose... 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900

Weight (Sparring)(kg):

(enter up to one decimal place eg 46.1)

Membership No:

Medical Conditions/Allergies:

*Emergency Contact details:

*Paying By:

PayPal

*Instructor and Club

Choose...NOT LISTED Aaron Cheong -- Club:First Class Martial Arts -- Email:firstclassmartialarts@gmail.com -- Phone:0731033138 Adam Morris -- Club:Kicks Taekwondo -- Email:adam@kickstaekwondo.com.au -- Phone:0421342222 Aja Wyman -- Club:One Taekwondo -- Email:admin@onetkd.com -- Phone:0411611162 Alan Harlick -- Club:Edge Taekwondo Gold Coast -- Email:ajharlick@hotmail.com -- Phone:0421566447 Ali Rahimi -- Club:World Taekwondo Centre -- Email:arahimi47@yahoo.com -- Phone:0425229391 Andy Rutten -- Club:Rt Xtreme Fight Team Australia -- Email:ruttentkd@icloud.com -- Phone:0433075218 Ashok Khadka -- Club:Nepal Taekwondo -- Email:carloslakerdis@icloud.com -- Phone:0414090609 Ben Hartmann -- Club:Hartmann Taekwondo -- Email:ben@hartmanntkd.com.au -- Phone:0410702357 Benjamin Flinn -- Club:Flinn Taekwondo Academy -- Email:instructor@flinntkd.com -- Phone:04449167422 Cameron Taylor -- Club:San Training Centre -- Email:Cameron@Santrainingcentre.com.au -- Phone:0437571540 Carlos Lakerdis -- Club:Lakerdis Martial Arts -- Email:Info@caboolturetkd.com.au -- Phone:0754282930 Cassandra Plain -- Club:Outback Taekwondo -- Email:outbacktaekwondo@gmail.com -- Phone:0488320483 Charanjit Singh -- Club:Midland Sports Foundation -- Email:MIDLAND.RJP@YAHOO.COM -- Phone:8307012322 Cheri Parks -- Club:Swordsman -- Email:Swordcheri@gmail.com -- Phone:0412440528 Claudia Murray -- Club:Taephoon Martial Arts Academy -- Email:taephoonmaa@gmail.com -- Phone:0407123800 Craig Drabsch -- Club:Reeves Taekwondo Greenbank -- Email:craigtkd@bigpond.com -- Phone:0414230942 Daniel Choi -- Club:Jmt Taekwondo -- Email:Dan.choi@live.com.au -- Phone:0426877080 Darryl Green -- Club:Edge Taekwondo Brisbane -- Email:green@edgetkd.com.au -- Phone:0414752313 David Jackson -- Club:Fit-For-It Taekwondo Academy -- Email:djacko66@hotmail.com -- Phone:0427907646 David King -- Club:Kma Brisbane -- Email:davidkingtkd@gmail.com -- Phone:0410645552 Diane Carn -- Club:Irontiger Taekwondo -- Email:dicarn@irontiger.com.au -- Phone:0413381611 Igor Geyl -- Club:5th Element Martial Arts -- Email:igorgeyl@gmail.com -- Phone:0411534582 Kangho Park -- Club:Pk Taekwondo -- Email:pktkdaus@gmail.com -- Phone:0432359848 Kate Eggar -- Club:Yun Hap Taekwondo Club Inc -- Email:president@yunhaptkd.com.au -- Phone:0408982248 Kijoo Kim -- Club:Hk Taekwondo -- Email:kimkijoo04@gmail.com -- Phone:0452385085 Maddy Houston -- Club:Factor10 Martial Arts -- Email:maddy@factorten.com.au -- Phone:0433901411 Master Barry Altan Han -- Club:Fastkix Martial Arts -- Email:fastkixtaekwondo@outlook.com -- Phone:0435760013 Master Paula Sitapa -- Club:Tonga Taekwondo -- Email:taekwonpaul@yahoo.com -- Phone:0414607082 Michael Tan -- Club:Tans Taekwondo -- Email:mt@tans.com.au -- Phone:0437437665 Mitchell Archer -- Club:Asp Taekwondo -- Email:mitchell.archer@hotmail.com -- Phone:0474762789 Paula Sitapa -- Club:South Peace Taekwondo -- Email:southpeacetaekwondo@xtra.co.nz -- Phone:640211860815 Rami Fraj -- Club:Ramis Thunder Martial Arts -- Email:ramis.thunder@yahoo.com -- Phone:0433556517 Rob Lister -- Club:Chos Taekwondo -- Email:qtfinc@powerup.com.au -- Phone:0411692260 Russell Macarthur -- Club:Russell Macarthur Taekwondo -- Email:info@macarthurtaekwondo.com -- Phone:0413873397 Sandipa Amgai -- Club:Sangrok Taekwondo Academy -- Email:Sandipa.amagai702@gmail.com -- Phone:+818047223040 Satyapal Singh -- Club:Negi Taekwondo India -- Email:negitaekwondoindia@gmail.com -- Phone:9872333957 Sean Green -- Club:Australian Unarmed Combat -- Email:seangreen210@gmail.com -- Phone:0413125217 Shirly Sien -- Club:Sun Bae Korean Martial Art -- Email:siehshirly@yahoo.com -- Phone:0434169394 Steve Manning -- Club:Reeves Taekwondo Wellington Point -- Email:Waynetkdkid@gmail.com -- Phone:0408077981 Sudip Giri -- Club:Birendranagar Taekwondo Dojang -- Email:meroaama77@gmail.com -- Phone:9855062826 Tung Nguyen -- Club:South Region Taekwondo And Aus Combat Martial Arts -- Email:nguyentkd@outlook.com -- Phone:0412571592 Wayne Reeves -- Club:Reeves Taekwondo -- Email:Waynetkdkid@gmail.com -- Phone:0417792028 Zhixiang Chen -- Club:Hero City -- Email:kwonxiang@hotmail.com -- Phone:0401580567