REGISTRATION FORM:    Click Here for the PDF version

Last Name:

First Name:

Date of birth:

DD

MM

YYYY

Gender:

M

F

ATQ#

City / Town:

Province / State:

Country:

Club’s name:

Master or Instructor’s name:

Club’s address:

Club’s telephone:

PLEASE CIRCLE

Keup Level:	8	7	6	5	4	3	2	1
Division:	4		3		2		1
Belt:	YELLOW		GREEN		BLUE		RED

Age Group for (COLOUR Belts only)        PLEASE CIRCLE

U7 2002-2001

U9 2000-1999

U11 1998-1997

U13 1996-1995

U15 1994-1993

U17 1992-1991

SENIOR 1990-1972

35+ 1971&-

Age Group for (BLACK Belts only)          PLEASE CIRCLE

POOM A 1991-94

POOM B 1995-97

POOM C 1998 and before

SENIOR

I, the undersigned, submit my registration for the present Taekwondo championship. I voluntary assume all the risks pertaining with my participation during this tournament. Furthermore, I extricate anybody associated with the organization from all responsibilities. What is more, I accept all decisions from the coach concerning the consolidations of divisions.

Athlete's signature:	Date:	DD / MM / YYYY
Parent/Guardian’s signature if under 18:	Date:	DD / MM / YYYY
Master or Instructor’s signature:	Date:	DD / MM / YYYY