Page 1 - Membership Application
All fields are REQUIRED. Please provide valid information for better assistance.
Email address *
Class Selection & Year
Beginners class is a 6-months course for each term.
2020
2021
2022
2023
2024
2025
1st Term January
2nd Term July
Full Name *
Mobile Phone *
Place of Birth *
Date of Birth *
MM
/
DD
/
YYYY
Age *
Gender *
Nationality *
Please provide a copy of Identification or Passport at Dojo
Current Kendo Grade *
Use "None" if unavailable.
Do You Have Special Medical Condition *
Required
If Anwer YES To Above Question Please Provide Details
Disclaimer
I hereby certify that the information provided in this application is correct and truthful.

I also hereby declare that I am not member of any other similar Kendo organization in Indonesia that is not associated with Indonesia Kendo Association, Jakarta Kendo Association and/or Jakarta Kenyu-kai.

I agree to abide by the rules, regulations and requirements of the Jakarta Kendo Association and/or Jakarta Kenyu-kai.

Any activities contrary to and/or harmful to the reputation and activities of the club may result in suspended and/or immediate removal of my membership.

All above personal information will keep confidential by Jakarta Kendo Association and/or Jakarta Kenyu-kai (Jakarta Kendo Club) and solely for the purpose of club activities.
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