CHRISTCHURCH - Registration Form

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Please complete one form per person to register for the Seminar on Saturday 27th July 2024 at :120 Paparoa St, Christchurch

Traditional & Kata 10.30am-12.30noon

Kumite 1.30-4pm

COST:

Single Session (Kata or Fight) $35

Two sessions (Kata & Fight) $50

Dojo Operators FREE

Please complete registration and make payment BEFORE Friday 19th July, pay:

Kyokushin NZ 12 3035 0629419 00

Particulars: JOE BLOGGS (person participating)
Code: CHCH
Reference: KATA, FIGHT or BOTH [CHOOSE 1 option]

Email *

Dojo *

Full Name *

Person participating in the seminar

Contact Name (Parent or Guardian for kids)

Gender *

Mobile Phone Number *

I am *

Date of Birth *

YYYY

What grade are you? *

8th kyu - blue belt

7th kyu - blue belt, black stripe

6th kyu - yellow belt,

5th kyu - yellow belt, black stripe

4th kyu - green belt

3rd kyu - green belt, black stripe

2nd kyu - brown belt

1st kyu - brown belt, black stripe

Shodan - black belt

Nidan

Sandan & above

Other:

Required

I would like to attend *

Acknowledgements *

Kyokushin Karate is a traditional Japanese martial art that requires intense physical exertion. Full contact fighting is a component of Kyokushin. While every effort is made to protect the comfort and safety of all students there is an inherent risk of discomfort and/or injury.

I understand and accept the risks

I understand that for the comfort and safety of myself and others I must abide by the dojo rules and follow instruction

I understand that every member and every parent/guardian of a member is expected to be vigilant to potential risk and contribute sensibly to the comfort and safety of all students.

Required

A copy of your responses will be emailed to the address you provided.

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