APPLICATION FORM - INTERNATIONAL KARATE FEDERATION SEATTLE

Please read before filling in the application form below.  

Principles of KARATE (please read carefully):

  1. Henceforth I shall faithfully train to strengthen my mind and body.

  2. I am willing to endure rigorous training to achieve my goal.

  3. As my strength increases, I shall seek to cultivate a gentle heart.

  4. I shall not use my skill outside the Dojo except in the most extreme circumstances.

  5. At all times I shall try to avoid inflicting injury upon another person.

  6. I will not brag about my skill nor use it maliciously.

  7. I shall train with the spirit of humility.

I have read and am in accord with the seven principles of the Hawaii Branch of the International Karate Federation. I will pay the first week of each month in accordance with the riles of the Dojo.

WHEREAS, the undersigned student intends to train in the art of Karate; and

WHEREAS, it is understood by said student (and by the parent or guardian of said student) that the following is involved in Karate: (a) physical contact between students; (b) physical contact between students and instructors; (c) rigorous exercises.

NOW, THEREFORE, the undersigned hereby expressly agrees, while training in the art of Karate, to release and save harmless the International Karate Federation, and its representatives, employees and teachers from liability for any injury to the student resulting from any cause whatsoever, excepting only the gross negligence of said representatives, employees, and teachers. It is further agreed by the undersigned that this release and agreement to save harmless shall extend to and include the owners of the building in which the Dojo (school) is located as well as any lessee or sub-lessee thereog.

I understand that all fees paid are non-refundable.

Student Name *
Student Name
Student Birth Date *
Student Birth Date
Student Phone *
Student Phone
Student Address *
Student Address
Parent / Guardian Name
Parent / Guardian Name
Parent / Guardian Phone
Parent / Guardian Phone
Parent / Guardian Business Name & Address
Parent / Guardian Business Name & Address
Emergency Contact (if other than parent)
Emergency Contact (if other than parent)
Emergency Contact Phone
Emergency Contact Phone