Embed Size (px)
Citation preview
Organise by : Indian Genseiryu Karate-do Federation (IGKF)Mumbai Open Karate-do Championship, 2018
Venue : Shahaji Raje Bhosale Krida Sankul, Andheri (West), Mumbai – 400 058. Maharashtra, INDIA.
On Sunday - January 28, 2018More details contact +91-9892152197 / 8805852197
PARTICIPATION FORM(FILL IN BLOCK LETTERS ONLY)
Passport Size
Photograph.
2. RESIDENCE :
3. DATE OF BIRTH :
7. KUMITE GROUP CODE : 8. KATA GROUP CODE : 9. T-SHIRT SIZE
5. WEIGHT : KGS. 6. RANK :
4. SEX : MALE FEMALE
PIN CODE
STATE / CONTRY :
TEL / MOBILE :
10. INSTRUCTOR NAME :
11. KARATE STYLE PRACTICE :
Surname / Family Name / Last Name
Participants Name
Father’s Name
( D D - M M - Y Y Y Y )
To, Camp Organising Division,
Indian Genseiryu Karate-do Federation (IGKF), Mumbai
Respected Sir,
I the undersigned assure that the information filled by me in this participation form is true and valid to the best of my knowledge, I have read the aforementioned rules, regulations and requirements of the
and have duly noted the contents of this circular I agree to abide by the same and I fully understand that My, or My Son(s)/Daughter(s)/Ward(s)/Student(s), participation in this will entail in a strenuous physical activity, which may lead to contingent. I shall not hold, assistant instructors, organizers, school authorities, Trustees, Principals or Teachers legally liable for any unforeseen incident, event, loss, injury, during or after my or my sons/daughters/wards participation in this
I fully understand that my or my Sons/Daughters/Wards/Students participation in this is provisional and subject to conditions. I agree that organizers hold all the rights for acceptance or rejection of participation forms. I shall not claim for any refunds whatsoever if my or my Son(s)/Daughter(s)/Ward(s)/Student(s) participation in the
is rejected or disqualified.
Thanking you,
Parent’s Sign. Participant’s Sign. Instructor’s Sign. (if below 18 year’s)
Mumbai Open Karate-do Championship, 2018
Mumbai Open Karate-do Championship, 2018
Championship,
Mumbai Open Karate-do Championship, 2018.
Championship
Mumbai Open Karate-do Championship, 2018
IGKF National Registered Office : A-1 Block, 3rd Floor, Makani Mansion, S. B. Road, Colaba, Mumbai - 400 005. INDIAIGKF National Admn. Office : 201, Sai Parag Enclave CHSL, Shirdi Nagar, Bhayander (E), District Thane - 401 105. INDIA
Tele-Fax : (91-22) 2814 8844 • Mobile : (+91) 98921 52197 / 95941 80300 • E-mail : [email protected] details about IGKF log our official website : www.mumbaiopenkarate-do.com OR www.genseiryu.in
DECLARATION
1. NAME :
