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Shito-Ryu

TECHNICAL SEMINAR, Q GRADING & BLACK BELT GRADING

Salutation

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Date of Birth

Weight (in kg)

Primary Mobile Number

Email ID

Father's Name

Coach

Current Address

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Street line 2

Landmark

Country

State

City

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Event

Belt Grading

Belt Fees

Total Fees

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Do You have any medical history?

Date

Place

I AFFIRM THAT I AM PHYSICALLY PREPARED AND CAPABLE OF PARTICIPATING IN THE TOURNAMENT. I ACCEPT FULL RESPONSIBILITY FOR ANY INJURIES AND ABSOLVE ALL ASSOCIATED INDIVIDUALS AND ORGANIZATIONS FROM LIABILITY. I UNDERSTAND THE RISKS, HAVE TAKEN PRECAUTIONS, AND COMMIT TO SPORTSMANSHIP AND FAIR PLAY.