Membership Form

Students Name

Contact Number

Birthday

Day

Month

Year

House of Swag Class Location

Address

School (If applicable)

Parent/Guardian Name

Relation to Child

Details of any medical conditions, additional needs, or any details you would like us to be aware of to provide a better experience for your child

Please list any other training you have or other schools/studios you have attended

Emergency Contacts (Please list at least 2 other emergency contacts different from the above give their name, relation to child and a contact number)

If the applicant is a minor, a parent or legal guardian must sign on their behalf.

By signing this application form, I acknowledge and agree to become a member of House of Swag and to fully comply with the club’s rules, regulations, and code of conduct as outlined on the House of Swag website at www.houseofswaghos.com/rules. I understand that it is my responsibility to promptly update House of Swag in writing of any changes to the information provided on this form and to remain informed about any

Name of Participant

Name of Guardian (If Under 18)

Signature

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