JAPAN SHITO-RYU KARATE DO KOHSHI KAI OF INDIA

Member of - Japan Karate Do Shito Ryu kohshi kai

Approved by – All India Karate-do Federation (AIKF)

Recognized by Govt. of India and Indian Olympic Association (IOA)

C150 sec 50 Noida-201301, G.B. Nagar, U.P.

Land Line: 0120-2442021 fax 0120-2576660,mob 09810175397/4.

APPLICATION FOR ADMISSION TO TEST FOR
______

NAME OF THE APPLICANT:______

FATHER’S NAME:______

POSTAL ADDRESS:______

______

CONTACT NUMBER:______

DATE OF BIRTH:______

PRESENT DOJO:______

REGISTRATION NUMBER:______

DATE OF JOINING:______

DATE OF LAST CERTIFICATION:______

BLOOD GROUP:

DETAILS OF TOURNAMENT / CAMPS ATTTENDED

I / My ward hereby undertake that the above mentioned information is true and correct to the best of my knowledge and no information has been willingly altered or cancelled.

Place:

Date: Signature of StudentSignature of Instructor

Signature of Sensei Rajkumar Chauhan

Dear Sir,

I / My ward, hereby present an application for appearing for the ______test in JAPAN SHITO-RYU KARATE-DO KOHSHI KAI OF INDIA (JSKKI) under Sensei Rajkumar Chauhan.

  1. I / My ward undertake to abide by the decision of Sensei Rajkumar Chauhan, Technical director and chief examiner, JSKKI regarding eligibility to appear for the test.
  1. I / My ward understand that the Technical Director’s decision will be binding and no reasons, whatsoever, shall be provided to the applicant / guardian regarding acceptance / rejection of the application.
  1. In case of acceptance of the application, I / My ward agree to abide by the rules of the test, as set by JSKKI or as notified from time to time.
  1. I / My ward also understand that acceptance of this application do not imply/guarantee success in the test.
  1. I / My ward promises to pay the requisite test – fee, as informed, before the date of the test; fee not being refundable under any circumstances.
  1. I / My ward promises to abide by the rules of the Karate School and display the discipline and dedication expected from a ______Karateka.
  1. I / My ward also promises to take part in all the activities conducted under the banner of my karate school JSKKI.
  1. I / My ward will not undertake any activity within/outside the karate school which is harmful to the reputation of the school.
  1. I / My ward will not train any individual / group or any other way exchange the knowledge imparted to me/my ward in this karate school without written permission from Sensei Rajkumar Chauhan.
  1. I / My ward do not have any objection for the karate school retain my ______certificate for a period of one year.
  1. If I/My ward fail to abide by the rules mentioned above and the karate school’s rules & regulation, I understand that disciplinary action may be taken against me, including cancellation of my certificate, dismissal from the State/Distt/Dojo/Karate School, etc.

Place:

Date:Signature of Student / Guardian