Licence Registrations

Name*
First Last
DOB*
Email*
Enter Email Confirm Email
Grade*
Previous Licence Expiry Date
Is this a New Registration or a Renewal?*
Only for new Licence applications
Have you ever practiced a martial art?
- yes
- no
If yes, please give brief details including affiliation, grade obtained & examiner
Have you ever been convicted of a crime of violence?
- yes
- no
If yes, please give brief details.
Upload your photo
Accepted file types: jpg, gif, png, pdf.
Do you have a medical condition or disability that could affect or prevent you practicing Karate?
- yes
- no
If yes, please give brief details.
I accept that training in karate could involve the risk of injury*
- I don't accept
- I accept
Select a Club*
HDKI Licence Registration Fee
Please select if you require a New Licence or Renewal
Lancaster University Karate Club
- Please see your Club Sensei for registration options.
Total
£ 0.00
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
CAPTCHA