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    POWERHOUSE TAE KWON DO CLUB

    TUESDAY LESSONS AT SWANMORE COLLEGE

    With Master Pat Donnelly

    GENERAL

    Thank you for your interest in the new lesson with Powerhouse Tae Kwon Do Club. We have aregularly maintained website (http://www.powerhousetkd.org.uk) which gives plenty ofinformation about the club, the lessons we offer and about Tae Kwon Do in general. Pleasetake a look at the website, which will hopefully answer any questions you have, but if not, pleasedo not hesitate to contact Darren or Tessa.

    The Tuesday lessons are held in the main sports hall at Swanmore College of Technology every5:30pm-6:30pm. Sessions cost 2 a week. Please make sure that you tick your name on theregister and pay each week so that we can keep a record of attendance. The first lesson is freefor all new students.

    Please arrive 5-10 minutes before the start so that the lessons can start promptly. Please bring adrink and wear comfortable shorts or baggy trousers with a t-shirt. Please remove all watches,

    jewellery, bracelets etc before the lesson for safety reasons.

    YOUR FIRST LESSON

    We need to get some information before the first lesson from all students. To save time at thatlesson, attached are the forms that we need completing. We also provide below the safety andfitness guidelines that you need to be aware of before you start the lesson.

    The forms that we will need completed before the start of the lesson are as follows: BTCB Individual Membership Application Form: Please complete personal details,

    sign and date for the date of your first lesson. Medical Questionnaire completed and signed New starter checklist, signed and dated for the first lesson. The points on this checklist

    are covered below, but if you have any questions, please do not hesitate to ask. Photo consent form for under 18s.

    Health

    The medical questionnaire should cover most areas, but please make the Instructor aware ofany health problems not covered on the list, or that arise at a later date.

    Health Risk Tae Kwon Do

    Tae kwon do is a vigorous form of exercise but can be adapted for those students who are lessfit. Each lesson will include a warm up and stretching before progressing to specific Tae kwondo Techniques. All students need to take part in the warm up, but they should ensure that theypay due regard to their own level of fitness, strength and flexibility. The class will be structuredto enable everyone to train at their own level, and by doing this, everyone should be able toprogress without injury.

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    If you have not participated in exercise for a long time, or you have any concerns about yourhealth/fitness, please see your doctor before joining the class.

    If, during a lesson, you have any difficulties with techniques, please bring it to the Instructorsattention.

    As with most martial arts classes, students of different grades participate in a lesson together.This way we all benefit from the knowledge of others. However, it is important that you onlyattempt the techniques for your grade that you are directed to do. Attempting to perform moreadvanced techniques before the basics are mastered increases the risk of injury, both toyourself and others.

    AFTER THREE WEEKS

    At then end of the third consecutive lesson, when you have had the chance to decide if youenjoy Tae Kwon Do, you will be required to pay 20 membership (cheques payable toPowerhouse TKD) in order to carry on training. This is an annual fee.

    At this stage you may also want to buy a Tae Kwon Do suit. These cost from 16 for childrenand 18 for adults. See Tessa or Darren to organise a suit.

    Members of PowerhouseTKD are welcome to come to any of the lessons offered by the club(subject to age and grade), just turn up and meet some of the other Instructors and students!

    FOR MORE INFORMATION

    Please contact Darren Bailey or Tessa Philpott preferably by [email protected] or [email protected] or by telephone on 07531805642.

    Powerhouse Tae Kwon Do (TKD) is a Community Amateur Sports Club (HM Revenue Ref.CASC 04538) that is run for the benefit of its members. Powerhouse TKD is part of Tae KwonDo Chung Do Kwan Great Britain and the British TaeKwonDo Control Board (the BTCB).

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    MEDICAL QUESTIONNAIREName:

    Address:

    Date of Birth: Telephone

    Occupation:

    DO YOU OR HAVE YOU EVER SUFFERED FROM: COMMENTSASTHMA YES / NO

    ANY HEART DISEASE YES / NO

    DIABETES YES / NOEPILEPSY YES / NO

    HIGH BLOOD PRESSURE YES / NO

    MIGRAINE YES / NO

    CANCEROUS CONDITIONS YES / NO

    PSYCHOLOGICAL CONDITIONS YES / NO

    CIRCULATORY PROBLEMS YES / NO

    ALLERGIES YES / NO

    HAVE YOU RECENTLY HAD: COMMENTSBONE FRACTURE YES / NO

    JOINT DISLOCATION YES / NO

    SURGERY YES / NO

    TORN MUSCLES YES / NO

    SPRAINS OR STRAINS YES / NO

    DO YOU CURRENTLY SUFFER FROM: COMMENTSBACK OR NECK PAIN YES / NO

    PAIN IN ANY JOINT YES / NO

    RHEUMATISM OR ARTHRITIS YES / NO

    HAVE YOU TAKEN, OR CURRENTLY TAKING: COMMENTSANY MEDICATION (AT PRESENT) YES / NO

    HAVE YOU EVER TAKENSTEROIDS

    YES / NO

    ANTICOAGULANTS YES / NO

    DO YOU USE: COMMENTSGLASSES YES / NO

    CONTACT LENSES YES / NO

    IF THE ANSWER TO ANY OF THESE QUESTIONS IS YES, PLEASE PROVIDE BRIEF DETAILS

    DECLARATION

    The information on this form is true to the best of my knowledge and belief. I appreciate thatparticipating in any form of physical exercise or sport carries inherent risks.

    SIGNED:(SIGNATURE OF PARENT / GUARDIAN IF APPLICANT IS UNDER 16 YEARS OF AGE)

    NB: A FAILURE TO DISCLOSE MEDICAL CONDITIONS WILL, IF A CLAIM IS REQUIRED, RESULTIN THE CLAIM NOT BEING PAID.

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    NEW STARTERS INFORMATION AND CHECKLIST

    IntroductionIn all sports, whether they are individual or team, a variable degree of risk of injury may exist. The level of riskcould be defined as very low (e.g. bowling) but in others it may be very high (e.g. rugby).

    There is a variable degree of risk of injury to individuals who practise Taekwondo and practice of it does nothave to be a concern to anyone if basic precautions are taken to ensure the health and safety of a participant.

    BT views the health and safety of its members as a very important part of training in Taekwondo and, to thisend, requires all new starters to read and digest the information below in order to avoid/eliminate or control, asfar as reasonably practicable, the risk of injury.

    It is very important for members, parents and carers to appreciate, accept and understand that the practice ofTaekwondo involves the use of kicks, blocks, strikes, sparring, self-defence and breaking techniques. It must alsobe pointed out that, in some cases, contact may be required as in self-defence and sparring.

    Members, parents or guardians are required to acknowledge the information listed below

    Safety RegulationsUnder no circumstances will a new starter be permitted to attempt techniques other than those of his/hergrade.

    New starters will not attempt to practice difficult moves unless permitted by an instructor and closelysupervised. Instructors, assisted by senior Dan grades, will ensure supervision of new starters.

    To ensure the safety of its students, the wearing of full body protection is compulsory when practicing 1 to 1free sparring, self-defence and one-step sparring. Please contact the instructor for further explanation ifrequired.

    As far as reasonably practicable or can be expected, instructors will provide proper supervision of all students

    during a training session assisted by senior Dan grades.No student will be permitted to enter the Dojang if suspected to be under the influence of alcohol or drugs.

    The club will follow the BT syllabus, which is designed to minimize, control and eliminate the risk of injury

    Health ProtectionMembers, parents or guardians must inform the instructor of any health problems, which could affect thestudent when training. The club may require a medical certificate confirming that the student is fit to practiceTaekwondo.

    Members, parents or guardians must inform the instructor of any past injuries, which may affect the training ofthe student. A medical certificate may be required confirming that the student is fit to train in Taekwondo.

    Whilst being a full member, members, parents or guardians must inform the instructor of any accident whichhappened outside the normal training sessions (e.g. in other sport/activity) and that may affect the training ofthe student. Following such notification, a medical certificate may be required.

    Students/parents/carers must inform the instructor of any health problems, which could affect the studentwhen training. New health issues (e.g. asthma, diabetes, confirmed pregnancy) must be immediately reportedto the Instructor. In all cases, BT may require a Doctors confirmation letter to continue training

    All accidents must be reported immediately to the instructor and recorded in the accident book.

    The use of drugs other than prescribed/permitted by a doctor is strictly prohibited.

    Preparation for ParticipationMembers, parents or guardians must understand and accept that Martial Arts and Taekwondo in particularrequires a fair level of fitness. This also includes undergoing a rigid warming up to ensure that the body is readyfor further physical demands thus avoiding injuries.

    However, students will not be permitted any form of contact when sparring until he/she has reached a certaindegree of control in his/her basic moves.

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    BT member club will ensure, as far as reasonably practicable, the health and safety of its members. It is equallyimportant that all students also look after their own health and safety by behaving sensibly and with care whilstattending a training session.

    New Starter Checklist to be explained by the instructorNew starters must review the list below and understand its contents before participating in the firstlesson.

    HEALTH ASSESSMENT

    Determine if member has any health problems or injuries that may affect training.

    Comments

    HEALTH AND SAFETY ADVICEExplain that the member needs to be physically fit and check fitness level.

    Comments

    HEALTH RISK

    Explain that Taekwondo involves a certain amount of physical contact.Comments

    NEW STARTER MONITORINGExplain that the new member will be monitored at all times by a senior grade. Make sure theyunderstand. Tell them that they must report immediately any health problems or injuries to theinstructor.

    Comments

    LIMITED ACTIVITYExplain that the new starter must not attempt anything other than what they are directed to do.

    Comments

    OTHER ISSUES

    Comments

    I the undersigned being the member, parent or carer, acknowledge that I have read, understood andaccepted all the points detailed in the New starters information 2009.Visit http://www.britishtaekwondo.org.uk/btcb-downloads.htmlfor a set of Health and SafetyGuidelines

    Signatures

    MemberName

    Signature Date

    Parent orGuardian

    Signature Date

    Instructor Signature Date

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    POWERHOUSE TAE KWON DO CLUB

    PHOTOGRAPHS AND RECORDED IMAGES

    Powerhouse TKD club recognises the need to ensure the welfare and safety of all young people in

    Tae Kwon do. As part of our commitment to ensure the safety of young people we will not

    permit photographs, video or other images to young people to be taken or used without the

    consent of the parents/carers and the young person.

    Powerhouse TKD club will follow the guidance for the use of images of young people, a copy of

    which is in the The British Tae Kwon Do Council Child Protection Policy and Implementation

    Procedures.

    Powerhouse TKD club will take all steps to ensure these images are used solely for the purposes

    for which they are intended which is the promotion and celebration of the actives of Powerhouse

    TKD club.

    If you become aware that these images are being used inappropriately you should inform

    Powerhouse TKD club immediately.

    I, . (insert parent/carers full name) consent to

    Powerhouse TKD Club photographing or videoing . (childs name)

    under the stated rules and conditions and I confirm that I am legally entitled to give consent.

    I also confirm that . (childs name) is not under a court order.

    Signed (parent).

    Date..

    I, . (childs name),consent to Powerhouse TKD Club photographing or

    videoing my involvement in Tae Kwon do under the stated rules and conditions.

    Signed (child)..

    Date.

    Please return this form to Tessa Philpott