We just need to register you as a member. Please fill out the form below. Please enable JavaScript in your browser to complete this form.Name *FirstLastAge *Address *Address Line 1CityState / Province / RegionPostal CodeEmail *Please note to use this email when booking future classes or making any payments with SKM.Phone *Medical HistoryDo you have a heart condition, high blood pressure or circulatory problems? *YesNoDo you have diabetes? *YesNoDo you suffer from epilepsy? *YesNoDo you ever experience pain in your chest when exercising or at rest? *YesNoDo you ever feel faint or suffer from dizzy spells? *YesNoDo you have back pain or joint conditions that could be exacerbated by exercise? *YesNoDo you have asthma? *YesNoHave you had any surgery in the past year that may affect your physical activity? *YesNoAre you aware of any other condition or injury that may give reason to modify your exercise programme? *YesNoAre you taking any medication? *YesNoAny medical details you wish to tell us about If you have ticked yes to any of the above questions please give detailsEMERGENCY CONTACT – NEXT OF KIN DETAILS (A CLOSE RELATIVE OR FRIEND)Emergency Contact Name *FirstLastEmergency contact Number *Terms & ConditionsData Protection *I AgreeData Protection : I agree for SKM Tactical to hold my data, That I have provided to conduct administration in relation to its activities SKM Tactical may use my contact details to inform me of events or changes in relation to its activities. Your data will be held within password protected files on our servers and on third party software provider servers. We will not share or divulge any information you provide to us to any third party. Your information will only be used by SKM Registered Staff. We will delete your data held by us after Six months from your confirmed leaving date or course end date. Your record of payment will be kept and held on third party financial institutions servers as appropriate to our payment collection method. If you wish us to remove your data held sooner or have a complaint please email us via our contact page on our website.Disclaimer *I agreeDisclaimer : I acknowledge that the activity, Close Combat Training I am to undertake is a relatively dangerous activity and that by participating in it I am exposed to certain risks. I acknowledge and understand that whilst participating in such activity: I may be injured; other person’s participation in such an activity may cause me injury or may damage my property. I may cause injury to other persons or damage their property. I assume the risk of and responsibility for any injury or property damage resulting in my participation in the activity. I acknowledge and understand that SKM Tactical recommends acquiring Personal Accident Insurance for sports participation or becoming a member of the International Close Combat Association which includes full insurance for its member{details of membership can be found on our web site)Signature * Clear Signature Submit