Registration + Waiver

Central Kyokushin Karate/Ultimate Truth LLC

Contact Information

2060 Vantage Hwy Suite 11

Ellensburg, WA, 98926, USA
ultimatetruthllc.com

[email protected]
509-607-9496

Instructions

Please read all sections carefully before completing this form.

Adult Registrant

First Name *

Last Name *

Phone *

Email *

Date of Birth *

Address *

Street Address

City

State

Postal Code

Sex *

Female

Male

Non-binary

Other

Student Age *

Minor (under 18 years of age)

Adult (18+ years of age)

Martial Arts Background and Goals

These questions help us better support your training goals.

What is your main goal for exploring martial arts training? *

How much time and energy do you typically invest in learning new skills? *

How did you discover Central Kyokushin Karate?

Please indicate your level of prior martial arts experience:

No formal training

Introductory or short-term experience

Foundational training (consistent but under 1 year)

Developed training (1–3 years, possibly ranked)

Extensive training (3+ years and/or advanced rank, police, military)

Medical Disclosure

Are there any pre-existing medical conditions, injuries, or health concerns that may affect safe participation in martial arts training? *

Yes

Please check all that apply.

Asthma or other respiratory conditions

Seizures, epilepsy, or neurological conditions

Heart condition, cardiac history, or high blood pressure

Diabetes or blood sugar regulation issues

Pregnancy

Current use of prescription medication that may affect physical activity

Prior or current joint or muscle injuries (e.g. back, knees, neck, etc.)

Recent surgery or medical procedure

Any other medical condition that may affect safe participation

Do you know of ANY OTHER REASON that would INHIBIT your physical activity or martial arts training? *

Yes

7-Day Free Trial - No Charge Today

Your card is saved now but will not be charged during your 7-day free trial.

Cancel any time during the trial and you will not be charged.

If you do not cancel before the trial ends, your membership begins automatically: your first monthly tuition is charged at the end of the trial, and tuition then renews automatically each month on that date until you cancel.

Once your membership begins, cancellation requires 14 days' written notice to [email protected]. See our Terms and Conditions.

Authorization - Adult *

Yes, I authorize CKK/UTLLC to store my card and, unless I cancel before my 7-day free trial ends, to charge my first monthly tuition at the end of the trial and then recurring monthly tuition on that date each month, whether or not I attend, until I cancel with 14 days' written notice.