wkff application

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					       World Kung Fu Federation , U.S.A.
                    Application for Membership
                      20 41st Ave. SAN MATEO, CA 94403 U.S.A.

                         Tel: (650) 574-9988 Fax: 650) 574-2877
Name                                     Sex      M( ) F ( )           Date of Birth

Name of the Group

Business address:

City                             County                      State                      Zip

Telephone (Day)                          (Evening)                           E-mail:

Home address:

City                             County                      State                      Zip

Graduate School or Education




Experience




Check one for membership
Membership dues once a year:
   A. Individual membership dues be $60
   B. Group membership dues shall be $80
   C. Honorary membership dues shall be $999
   D. Life time membership dues shall be $1,999
I certify that I have voluntarily submitted this membership application to W.K.F.F. and agree to abide by
all rules and regulations. I further certify that all of the information I have provided is true and correct to
the best of my knowledge and belief. I fully understand and agree that participating in W.K.F.F. events
and tournaments carries the risk of accidental injury and hereby assume that risk. I release from liability
and waive any claims I may have against W.K.F.F its officers, judges, referees, employees, and
volunteers.

Applicant’s Signature:__________________________________________Date:__________________

				
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posted:9/18/2012
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