Admin : UK Karate-Do Goju-Kai

Membership Number:

First Name

Mr. Miss

Post Code

Address

Date of Birth

Mobile No.

Email

Photo

Surname

Telephone No.

Height (in cm)

Membership Start Date

Account Password

Does the applicant suffer from Astama. Yes No

Please mention any disabilities.

Please mention anything else that you think may help the instructor during coaching. (i.e. shy,lacks confidence etc.)

Does the applicant wear Glasses/Lenses. Yes No

Please mention any other martial arts studied and any grades obtained.

Enrollment Fee to be paid: 10.00

Dvd Volume.1 (Optional for beginners)

Get DVD (£20.00)

Get syllabus (£10.00)

Annual Membership & Insurance to be paid: 20.00

Karate Suit (Complete Kit)

I already have a Goju-Kai Karate suite

Bronze Package - £45.00

Silver Package - £55.00

Gold Package - £85.00

Colors are Chihan’s dojo
Colors are Satellite dojos
Colors are Charity dojo

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