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(Motobu-Ha Shito-Ryu)
MEMBER
JAPAN KARATE DO- KUNIBA KAI INTERNATIONAL
Recognised with
JAPAN KARATE - DO FEDERATION
APPROVED BY
ALL INDIA KARATE DO FEDERATION
MEMBER WORLD KARATE DO FEDERATION & ASIAN KARATE FEDERATION
RECOGNISED BY - GOVT. OF INDIA & INDIAN OLYMPIC ASSOCIATION
(MINISTRY OF SPORTS & YOUTH AFFAIRS)
INTERNATIONAL PRESIDENT &
WORLD
CHIEF INSTRUCTOR
SOKE KOZO KUNIBA
PRESIDENT, CHIEF INSTRUCTOR & TECHNICAL DIRECTOR
INDIA
SHIHANDAI
NAVAL DATTA ( YONDAN ) JAPAN
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Name
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Father's Name
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Date of Birth
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Sex
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M
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Permanent Address
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Telephone No. Resi
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E-mail Address
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Country
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Passport No
( for foreigners only )
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Office
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Occupational Details
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Father's Occupation
in Detail
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Office Address
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Reasons of Joining
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Previous Experience
in Karate or any
other Martial Art
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If you are applying for affiliation then please explain
your previous history, your master National &
International achievements or belts and strength of
students and why do you want to join us.
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If so, the rank held
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Are you ailing from contagious / serious illness
Yes
No
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Are you medically fit to undergo strenuous exercise,
if no please explain
Yes
No
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State
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P.K.T.P.
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Yes
No |
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Date
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Address of Dojo
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Class Time and Days
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TERMS AND CONDITIONS OF TRAINING :
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1. Karate is for Self-Defence. If develops character
patience, tolerance and humanity.
2. Karate emphasis on Speed of movement and keenness
of mind.
3. Karate combines body with soul.
4. If the applicant is a minor (i.e. below 18 years
of age) the application form should be countersigned
by the parent or guardian.
5. The association or the instructor will not
be responsible in any way for injury (physical or
mental) received at or during the
time of training of Karate or any other associated
martial art nor is he responsible, when injuries are
caused by its members of malpractised.
6. The grading test will be held once in 4 to 6 months.
According to performance of student. Student must
come in white - Gl.
7. Monthly fee must deposit on the date of admission,
without covering the classes of month you have missed.
AGREEMENT : I will not use Karate for unlawful
activities. I will not impart the training I receive
without necessary permission from the Institution.
I have carefully read the prospectus and I am agree
to abide by the Rules and Regulations of the Institutions.
On my misbehavior/indiscipline my membership stands
cancelled. I will learn Karate at my own risk. My
guardians don't have any objection for Karate training.
In case of injury or damage or loss, if any, I myself
will solely be responsible for the same.
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NOTE : The form should be
accompanied with two recent passport size photographs
(including one to be affixed on the form). The chief
Instructor or the instructors of the respective dojos
have the poser to allow or reject any admission form
without assigning any reason.
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