• International ShinKenDo Organisation Japan 国際新剣道機構ジャパン

  • Student Name


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  • Parent/Guardian Information (if under 18)

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  • Alternative Emergency Contact

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  • Additional Information

  • Decleration

    I understand that ShinKenDo allied activities carry a risk of injury and that the International ShinKenDo Organisation Japan are not responsible for any injuries or loss suffered as the result of participating in these activities.
    I shal not hold the instructor assistant instructor or any Organisation committee for any inuries suffered

    Medical Authorization

    In the event of an injury or medical emergency, I allow International ShinKenDo Organsiation to provide first aid, arrange transport to a medical facility, and authorise emergency treatment as recommended by a doctor for the students named above.

    I understand that all reasonable efforts will be made to contact the students parent and/or emergency contact if an injury or medical emergency occurs.

  • Confirmation

    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.


  • Payment
    Please complete the details  below
    Please state if renewals or membership application.

    NOTE:
    Membership allows students to sit grading exams.
    Non Memberships wll refrain students from being tested or promoted for belt rank
    please renew your membership yearly
    Membership yearly fee (€12)     (¥1000)    (£10)


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