Nepalese Shito Ryu Karate Academy of Canada NSAC Admission Form 2012

Document Sample
Nepalese Shito Ryu Karate Academy of Canada NSAC Admission Form 2012 Powered By Docstoc
					        Nepalese Shito-Ryu Karate Academy of Canada (NSAC)
                                 (Affiliated with Karate Ontario)
                         Development,        Discipline,        Dynamism
                                Training Registration Form

Registration #:________________________

Last Name: ___________________________First Name:________________________________

Address: _____________________________City: ____________________Province:__________

Postal Code: _____________ Date of Birth: DD_____ MM_____YY_______ Gender: M                 F

Phone#:____________________________ E-mail: ____________________________________

Emergency Contact Person:___________________________Relationship:__________________

Telephone #_________________________ Mobile #:__________________________________

Note:

   1. Insurance of any accidental during the training or participating tournament session is

        automatically covering with the admission fees of the Karate Ontario.

   2. Every year there will be renewal charge for the Karate Ontario per their regulation.

   3. Each & Every grading upgrade will be charge separately.

   4. Registration with the academy will charge one time only apart from monthly training

        fees.

Name of the Guardian: ______________________

Signature of the Guardian: _______________________ Date: ___________________________

Signature of the Witness: _________________________ Date:___________________________

Approved by the Instructor: _______________________ Date:___________________________

Note: This training is launched with the kind cooperation of Canadain Newa Guthi.

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:49
posted:9/28/2012
language:English
pages:1