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World
Applicatio=
n for
Registration / Membership
PLEASE PRINT IN CAPITAL LETERS AND COMPLEATE ALL SECTI=
ONS
Surname:
Please Attach Passport Size photo=
Forenames: &=
nbsp; &nbs=
p; &=
nbsp; Date
of Birth: &=
nbsp; &nbs=
p;
Address:
&=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; Post Code =
Telephone:<=
span
style=3D'mso-tab-count:1'> =
E-Mail: &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp;
1, Have you ever practiced a martial a=
rt? &=
nbsp; &nbs=
p; &=
nbsp; 2, Do you hold a current WJJF lic=
ence
If yes please state wh=
at
grade you obtained &=
nbsp; &nbs=
p; &=
nbsp; If yes please give det=
ails
=
&nb=
sp; =
&nb=
sp; =
&nb=
sp; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp;
3, Do you suffer from any of the follo=
wing? &=
nbsp; &nbs=
p; &=
nbsp; 4, Have you ever been convicted o=
f
Migraine, Epilep=
sy,
Hay fever, Diabetes,  =
; &n=
bsp;  =
; a crime of viole=
nce?
If so please
Nervous Disorders, Hea=
rt
Disorders, &nb=
sp; =
&nb=
sp; give details…
Haemophilia, Raspatory
Disorders or any &nb=
sp; =
&nb=
sp; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; =
Medical conditions.
=
&nb=
sp; =
&nb=
sp; =
&nb=
sp; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; =
5, Do you accept the fact that details
regarding &nbs=
p; &=
nbsp; Senior
Registration
YES / NO
Your registratio=
n and
on going training will
Be stored on a data
base? YES / NO &=
nbsp; &nbs=
p; &=
nbsp; Junior
Registration
YES / NO
Declaration: <=
/span>On completion of this fo=
rm of
application for registration to the World Ju-Jisu Federation, I accept that
participation in martial arts carries the risk of serious injury and I here=
by
exonerate the World Ju-Jitsu Federation from losses, either personal or of
articles, or injuries of any nature or cause whatsoever. I further declare =
that
I am fit to train in martial arts.
Signature:<=
span
style=3D'mso-tab-count:6'> &=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; Date=
: &=
nbsp; / &=
nbsp; / &=
nbsp; =
&nb=
sp; =
&nb=
sp; =
&=
nbsp; &nbs=
p; &=
nbsp; &nbs=
p; &=
nbsp; =
&=
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p;
World
1043a
Phone: 02-9804-1115