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Inspiration Taekwondo

Contact Mr Connolly 085-7400638

  • Annual Membership Form
  • Class Venues and Times
  • News and Events
  • Information for Students
    • Questions for Grading
    • Colour Belt Grading Examination Request
    • Kids/Kubs Grading Form
    • Student Oath
    • Tenets
    • General Choi Hong Hi
    • Hand and Foot
    • Taekwon-Do Patterns
    • Belts – Gradings
    • Black Belt Checklist
    • Club Rules
    • FAQ’s
    • ITA National Policy for Young People
  • Annual Membership Form
  • Class Venues and Times
  • News and Events
  • Information for Students
    • - Questions for Grading
    • - Colour Belt Grading Examination Request
    • - Kids/Kubs Grading Form
    • - Student Oath
    • - Tenets
    • - General Choi Hong Hi
    • - Hand and Foot
    • - Taekwon-Do Patterns
    • - Belts – Gradings
    • - Black Belt Checklist
    • - Club Rules
    • - FAQ’s
    • - ITA National Policy for Young People
Home :: Annual Membership Form

Annual Membership Form


Membership Details and Medical Questionnaire

Personal Details


This form is confidential and not disclosed to any other party.
Student Name in full please
Mobile number is preferable
Please indicate your preferred method of payment
Please indicate your preferred method of payment
If none apply please state "None"

Before submitting this questionnaire we ask that you read the following points very carefully


EMERGENCY / ILLNESS: In the event of illness, having parental responsibility I give permission for medical treatment to be administered where considered necessary by a nominated first aider or suitably qualified medical practitioner. If I cannot be contacted and my child needs emergency hospital treatment I authorise a qualified medical practitioner to provide emergency treatment or medication. *

PHOTOGRAPHS: I understand that photographs will be taken at or during Taekwon-Do related events and will only be used in the promotion of Taekwon-Do and Inspiration Taekwon Do. *

CODE OF ETHICS FOR YOUNG PEOPLE: I hereby consent to the child named above/overleaf, participating in activities of Inspiration Taekwon Do in line with the Code of Ethics for Young People. I will inform the instructors or administration of Inspiration Taekwon Do of any changes in the above information immediately. *

The Code of Ethics for Young People is available on the website for reference

I confirm that I have answered the above questions correctly to the best of my knowledge; I understand that Taekwon-Do is a martial art and a contact sport and therefore my instructor, Inspiration Taekwon Do or agents acting on behalf of the above cannot be liable for any injury that may be sustained as a result of participation in the programme. I accept that the onus is on me as a parent / guardian or adult to ensure that my child or I have adequate personal insurance cover in case the need for medical treatment or otherwise should arise as a result of injury. *

Irish Taekwon-Do Association School

Customised Kit

About Inspiration Taekwondo

Based in the Midlands of Ireland Inspiration Taekwondo holds classes in multiple venues around the Westmeath area.

For more information please contact Mr Rodney Connolly on 085-7400638