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Home
What is Karate
Dojo Etiquette
Uniform
Grading
Instructors
Trial
Branch Membership
JKAA
Find Us
Competition
JKA BRIBIE ISLAND
CHAMPIONSHIPS
Thursday 5 March 2020
5pm registration
VENUE:
Bribie Island Community Hall
96-108 Arcadia Drive
Woorim
Bribie Island 4507
*
Indicates required field
Competitor Full Name
*
First
Last
Gender
*
Male
Female
Age
*
Date of Birth
*
Branch
*
Bribie Island
Brisbane
Sunshine Coast
Toowoomba
Waterford
Other
JKAA Membership Number
*
Current Grade (KYU Grade/Dan Grade/Belt Colour)
*
Participating in:
*
Kata ($15.00)
Kumite ($15.00)
BOTH ($25.00)
Safety equipment required for kumite events: Clear (transparent) mouth guard, fist protectors, and chest protectors.
I understand full payment will be required via branch instructors prior to participation in this event. By completing this form, I am securing my space in the tournament and understand no refunds are given.
*
I AGREE
Emergency Contact Name
*
First
Last
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Contact Number
*
MEDICAL CLEARANCE
Please state any medical conditions/allergies.
*
Do you have any additional condition which prevents you training and competing in this event?
*
Yes
No
Do you have any condition which may endanger others training and competing in this event?
*
Yes
No
If you have answered yes to questions 1 or 2, a medical clearance certificate will be required to be completed. This must be signed and stamped by your doctor giving approval for you to participate in the JKA Australia Inc. Event.
WAIVER
By agreeing below, in consideration of, and as a condition of acceptance of my participation in the JKAA seminar, for myself, my heirs, executors and administrations, hereby waive all and any claims, rights or cause of action, which I or they might otherwise have, arising out of any loss of life, injury, damage or loss of any description whatsoever which I may suffer or sustain in the course of, or as a consequence of, my entry or participation in the seminar and/or competition.
This waiver extends to and operates separately in favour of all persons, corporations and bodies involved or otherwise engaged in promoting or staging the seminar and competition and the servants, agents, representatives and officers of any of them.
As the competitor or parent or guardian if the competitor is under the age of 18 years.
*
I AGREE
Submit
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What is Karate
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