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Membership Application

Please fill out the information below. This does not complete your application; medical information is still needed. To complete your application, please download this Medical Form and bring it to your dojo.

Name*
First Last
Phone*
Alternate Phone
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City Province Postal Code
Birth Date*
MM slash DD slash YYYY
Gender*
- Male
- Female
- Other
Emergency Contact Name*
First Last
Emergency Contact Phone*
Relationship
Do you have previous martial arts experience?*
- Yes
- No
Previous Style/Association
Level Attained (Kyu/Dan)
Instructor's Name
Karate BC Number
How did you hear about Gima-Ha?
Agreement*
I, the above named person, hereby apply for membership in Sekukan Abbotsford GIKF. If this application is approved, I agree to abide by the Constitution, Bylaws, Rules and Regulations, Codes of Conduct and Guidelines of Gima-Ha International Karate Federation Canada and agree that my membership dues shall be paid in accordance with the policy of the Association and Karate BC as required. Waiver: It is understood and agreed that Gima-Ha International Karate Federation and Sekukan - Abbotsford GIKF as well as instructors cannot be held responsible for bodily injury arising from participation.
- I agree
- I do not agree
Comments
This field is for validation purposes and should be left unchanged.