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MEMBERSHIP APPLICATION

黒蠍忍術会に入会せよ

JOIN OUR MARTIAL ARTS SOCIETY FROM ANYWHERE IN THE WORLD!

A picture of a Black Scorpion with Japanese Kanji and Ninja Training in the background

Join the Black Scorpion Ninjutsu Society

Honoring the Past. Uniting the Present. All Ryu & Martial Artists Welcome.

Become an official member today! Open to all practitioners, with leadership positions available for those interested in becoming Regional Representatives.

Member Perks:

2 Custom Embroidered Patches & 2 Weatherproof Decals
Digital Membership Certificate & Founder's Art Recognition Certificate
Society Newsletter & Priority Invites to all future events and camps

Full Legal Name *

Preferred Name/Nickname

Are you 18 or older? *

Yes (Proceed with registration)
No (Stop: Members & Students must be 18 or older to register)

Date of Birth *

Phone Number (Mobile) *

Email Address *

Why do you seek membership with the Black Scorpion Ninjutsu Society? *

Have you ever trained in the Martial Arts? *

Yes
No

If yes, please list the Style/Discipline: (e.g., Taekwondo, BJJ, Muay Thai, Wrestling)

United States Membership: $50.00. We will email you with a payment method of your choice. Please Choose Below:

Venmo
PayPal
Zelle
CashApp
Money Order
Credit or Debit Card
Renewal (FREE).

International Membership $65.00. We will email you with a payment method of your choice. Please Choose Below:

CashApp
Credit or Debit Card
Renewal (FREE).

How did you hear about us? *

Google Search
Social Media (Facebook/Instagram)
Referral
Other (Not Specified).

If referred by a current student, please share their name so we can thank them

Mailing Address (Include City, State/Province, Postal Code, and Country) *

Is this your preferred mailing address for membership materials?

Yes
No

Would you like to receive our newsletter?

Yes
No

Membership, Participation & Media Consent *

I consent to the use of my image and video for promotional purposes.
I DO NOT consent to the use of my image and video.

Your Message, Questions or Comments

Are you interested in becoming a Regional Representative for your area?

Yes
No

Are you a Martial Arts Founder?

Yes
No

If yes, what is the name of your style/art?

Physical Fitness: I affirm that I am in good physical condition and have no medical impairments that would prevent me from safely participating in physical training. I agree to train at my own pace and take full responsibility for my own safety. *

I have read, understood, and agree to the terms.

Lawful Use of Skills: I agree that all martial arts and survival skills taught by the Society are for self-defense, personal development, and lawful purposes only. I will not use these skills maliciously or unlawfully. *

I have read, understood, and agree to the terms.

Release of Liability: I hereby release, waive, & forever discharge the Black Scorpion Ninjutsu Society, its instructors, founders, & affiliates from any & all liability, claims, demands, or causes of action arising out of negligence or personal injury. *

I have read, understood, and agree to the terms.

Assumption of Risk: I understand that training in martial arts, ninjutsu, fitness, and outdoor/survival activities involves inherent risks of physical injury, illness, or property damage. I knowingly and freely assume all such risks, both known & unknown *

I have read, understood, and agree to the terms.

Your privacy is important to us. Your personal information will only be used for society membership and communication purposes and will never be shared.

Send me a copy

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The Black Scorpion Ninjutsu Society: Open Doors to Every Ninjutsu Practitioner.

Nashville Tennessee’s Home for Traditional & Modern Ninjutsu, Classical Martial Arts, and Self-Defense.

The Black Scorpion Ninjutsu Society & Academy of Martial Arts - Founder, Bobby Calvert AKA Ninja Bob

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