IMA Karate Grading Registration Form October 2024

Integrated Martial Arts Pty Ltd

IMA Karate Grading Registration Form - October 2024

To be completed by the student if 18 years or older, otherwise by a parent or guardian. Please complete one form per student.

Student First Name (to appear on certificate)

Student Last Name (to appear on certificate)

Please select your class

Contact Email (same as linked to membership profile)

Current Belt Grade (example: Yellow with white stripe, Green with Black Stripe etc)

Current age of student (if student is under 18 years old)

Current Belt Size? Current size can be found on belt tag. Example: 00, 0, 1, 2, 3, 4, 5, 6 etc.

Do you need a larger belt size? If yes, please nominate a size. Example: 00, 0, 1, 2, 3, 4, 5, 6 etc.

Please select the day you will be grading

Name of Parent / Guardian completing this form (if student is under 18 years old)

You (or your guardian named above if under 18 years old) authorises Integrated Martial Arts Pty Ltd to charge your card linked to your membership account $15 grading recovery fee. This fee is only applicable if you successfully pass your grading.

Yes, please charge my account $15 grading recovery fee if I am successful at the grading.

Questions (if any)