Multi Game One -2- One “An Evolution in Taekwondo”
Name:
Age:
EXPERIENCE
DOB:
B.T.C.B LICENCE
1st Timer
INSTRUCTORS COMMENTS
Poor
Average
Weight:
Kg’s
Sex:
Grade:
Height:
M No:
Exp Date:
Kup/Dan
Good
V Good
Team:
NO OF PREVIOUS GAMES _______
GAMES REQUIRED
1
cm
Excellent
PAYMENTS
2
1 GAME
£15.00
1 ~ 1 PATTERNS
2 GAMES
£20.00
KUP GRADE 12 YEARS & UNDER
PATTERNS
£8.00
Instructor:
M Number: M
KUP GRADE 13 YEARS & OVER
TOTALS
Contact Tel:
DAN GRADE 12 YEARS & UNDER
PAID
Email:
DAN GRADE 13 YEARS & OVER
£
YES NO Cheques payable to: “Ultimate Taekwondo”
DECLARATION
ENTRIES & INFO
VENUE
I hereby submit this application on the understanding that the above-named person is fit
to take part in these Championships and the details provided are all correct to the best of
my knowledge.
Ultimate TKD
4 Jenkinson Grove
Armthorpe
Doncaster
DN3 2FJ
The Metrodome
I also understand that no claim whatsoever will be made against any of the Organizers,
coaches, players, officials or staff in the event of any injury or loss that might be sustained
during or after this event.
Signed…………………………………………………………….. (Parent or Guardian for under 18’s)
Tel :
07742 479273
Email: [email protected]
Queens Road
Barnsley
S71 1AN