Tora No Kai - Grading Form

Declaration

I, the undersigned, hereby make application to be tested for a grade in Kyokushin Karate and, should my application be successful, I agree to abide by the rules of such grading.

I understand that any pre-existing medical condition, physical disability, intellectual disability, and/or injuries must be underwritten by a medical certificate and attached to this grading form. It is my responsibility to ensure I advise of this. Failure to do so could result in my application for grading to be rejected.

Furthermore, in consideration of my acceptance to participate in the said grading, for myself, my heirs, executive and administrators, I hereby waive any claims, rights of cause or action which I might have arising out of any damage, loss, or injury of any description whatsoever which I may suffer or sustain in the course of or consequence upon my entry in the said grading. This waiver, release, and discharge shall operate separately in favour of all persons, other participants, and all bodies.

Applicant's Details

First name

Last name

Multi-line address

Country/Region

Address

City

Zip / Postal code

Applicant's Phone Number

If applicant is under 18yrs, provide phone number of parent/guardian.

Applicant's Email

If applicant is under 18yrs, provide email of parent/guardian.

Gender

Male

Female

Other

Age of Applicant

Date of Birth

Day

Month

Year

Current Karate Grade

*Applicant's kyu/belt prior to the grading. 'Black Stripe' refers to the black cotton tape at the end of the applicant's belt.

IFK Member Number

*Number found at the back of IFK issued membership card. If unissued, please disregard.

Dojo applicant is attending

Signature

Signature and declaration of applicant, or parent’s/legal guardian’s consent in respect of persons under the age of 18 years.

I consent to the declaration and participation.

Applicant’s or Guardian’s Signature:

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Date Signed

Day

Month

Year

If a parent or guardian has signed, please state your relationship to applicant:

The information you are providing in this entry form is being collected and will be used only for the purpose of your registration with the International Federation of Karate and the International Federation of Karate Australia Inc. (IFK Australia). It will only be disclosed to the executives of these organisations and their affiliated insurance company/companies if necessary.