You are one form away from starting training with us!

Please fill out the membership details below paying close attention to the medical questionnaire. If you have any questions please just contact us by email at training@leamingtonspakravmaga.com or call 07722 722 580

See you soon !

Information about you:

Home Address:

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Fitness and Medical:

Do you smoke?

Do you have any medical conditions that we should be aware of that may affect your training? For example: allergies,epilepsy, loose joints, back problems, diabetes, old injuries, etc

Do you know of any reason that you should NOT engage yourself in a physical activity that could involve high heart rate, contact or impact?

Have you ever been convicted of a crime involving violence?

Have you ever been diagnosed with a heart condition, recently had chest pain either when exercising or not, ever feel faint or have dizzy spells?

Have you ever been told you have high blood pressure, or do you suffer from asthma, breathing difficulties, diabetes or epilepsy?

Your Order:

Item Payment Interval Amount
Yearly membership Single £ 420

Credit card details:

Billing Address:

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