goju ryu karate i self … · terms and conditions of membership 1. definitions unless otherwise...
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SENSEi EMMA WENTZEL 4 th Dan Instructor 93 Randpark DriveRandpark Ridge2194Cell: 083 681 9918 Tell: 011 791 0765 Fax: 086 551 2607 [email protected]
WWW.SEISHINMAA.CO.ZA MARTIAL ARTS ACADEMY
GOJU RYU KARATE I SELF DEFENSE I WKF SPORT KARATE
STUDENT PARTICULARS First Name/s I I Last Name II.D Number I I Relation to
IMember
Date of Birth I YYYY / MM /DD Guardians IPostal Address Code I
Physical Address IEmail Address I Please PRI NT Clearly
Cellphone I Telephone I Fax I Medical Ailments
PAYMENT METHOD Cash
1EFT I
Joining Fee I I Terms I I Monthly I I Annual I I
EMERGENCY CONTACTS
D octor I I Tell No. I I Next Of Kin I I Tell No. I I
Date Started .. I ___________ _
Signature* .. I ____________IHOW DID YOU HEAR ABOUT US? _I _________ I
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