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APPLICATION FORM

APPLICANTS DETAILS (Note: if this section is incomplete, your application may be rejected completely)
     
Full name of Applicant Date of birth
Postal address Telephone
    Mobile
E-mail address * Country
   
 
IN CASE OF EMERGENCY
   
Next of kin
Postal address Telephone
Relationship to applicant Mobile
 
 
MARTIAL ARTS DETAILS (Note: if this section is incomplete, you may participate socially but not train)
   
Name of Main Organisation
Name of club
Main discipline
(e.g karate-do, kobudo etc)
Grade
   
License / Insurance status
I have a license / I need a temporary budo license for the event*
 
Licensing Body
License No License Expiry Date
Details of health / medical problems
 
     
PERSONAL NEEDS & REQUESTS    
     

Dietary arrangements and requests:

If this section is left incomplete, organisers will, by default, provide any choice of meal / diet available.



 

 

 

 

 

I wish to attend the event dinner

     
   
Please Choose:  

Vegetarian / Halal / Kosher / Any

     

If other, please state

 
If your dietary needs cannot be met, what would you prefer to do:
 

I would prefer to pay extra for meals
(e.g. external catering),

   

I would prefer to make my own dietary / meal arrangements

   
     
Special needs & health issues:  

Do you have any special needs or health issues?

     

If yes, please provide details:

   

Travel arrangements and requests

(please tick one box and fill in the additional details, where required) :

If this section is left incomplete, you may be expected to make your own travel arrangements (without any assistance, e.g. pick ups etc.).

Please note that this section relates only to local travel within London .

 
 

I wish to make my own travel arrangements

   

I wish to request an escort to
or from the airport

   
Outward flight  

Flight lands at which UK airport?

   

Flight number (in full):

   

Flight arrival time:

   

Pick-up time needed:

   
Return flight  

Flight departs from which UK airport?

   

Flight number (in full):

   

Flight departure time:

   

Drop-off time needed:

   
   

Partners and guests:

B: Each guest is required to fill in a separate application form of their own, whether or not they are training.

Participants are responsible for each guest that they bring to the event.

 
Are you intending to bring any guest(s)?
If yes, please provide Name / age / requirements:
Answer Yes or No:
1)  

Name

   

Date of birth

   

Training or Non Training

   
2)  

Name

   

Date of birth

   

Training or Non Training

   
3)  

Name

   

Date of birth

   

Training or Non Training

   
   
     
     

Children:

B: Each child is required to fill in a separate application form of their own, whether or not they are training.

Every child is the responsibility of the parent / guardian at all times during the event.

 

 
Are you intending to bring other children?
If yes, please provide Name / age / requirements:
Answer Yes or No:
1)  

Name

   

Date of birth

   

Creche Facility Needed

   
2)  

Name

   

Date of birth

   

Creche Facility Needed

   
3)  

Name

   

Date of birth

   

Creche Facility Needed

   
     
 
STANDARD RULES REGARDING EVENTS

Insurance / Licence & Finance

•  All participants must a valid licence & insurance which must be shown at registration prior to participation in the event.
•  The Local Organizing Committee cannot accept responsibility for any loss, theft or damage of personal items.
•  It is the practitioner's own responsibility to look after their own belongings.
•  A temporary budo licence / insurance may be issued but is only valid for a single event/course and costs £5.50.
•  All cheques should be made payable to “LKDSA” and posted to:

LKDSA
PO Box 55688
London
W9 4AQ
United Kingdom

•  Bank transfers should be made to:

•  Name of account – LKDSA
•  Sort code (UK bank transfers only) – 309640
•  Account number (UK bank transfers only) -01965923
•  Name of bank – Lloyds TSB plc
•  Branch – Paddington (309640)
•  Branch Identification Code (BIC) – LOYDGB21062
•  International Bank Account Number (IBAN) – GB92 LOYD 3096 4001 9659 23

Please include any handling fees at either end of the bank transfer

Dress code :

All guests / participants are requested to respect the dress code that we adhere to during keiko.

•  Everyone

•  Please make yourself presentable for each practice (clean / tidy keiko gi or hakama ± tabi / zori)
•  No outdoor shoes are permitted in the dõjõ. Zori, clean tabi or bare feet are the only options.
•  No hats; No jewellery, including rings; No external piercing. Headscarves / headgear may be worn for ...religious / medical purposes.
•  No watches or bracelets (except medic-bracelets).
•  Good hygiene is essential.

  Gender specific:

•  Ladies / girls are expected to wear a t-shirt under the keiko gi
•  Chest and groin guards are permissible and, indeed, recommended

Communications:

Please note that proof of postage is not the same as proof of receipt. Until you receive an email confirmation from the event organiser (or your own group leader) please do not assume that our application has been received or has been successful.

DECLARATION
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I solemnly declare that the details I have given are true and correct at the date of the signature below. I promise to participate in the above event with honour and integrity and will not do anything that may bring shame or disrepute to me, my co-participants, my teachers or my club. I acknowledge that I am held responsible for the conduct of any partners or guests that I bring to this event. I further acknowledge that there may be delegates at this event from many different cultures and ethnic origin. I promise to treat everyone with equal respect and fairness, with no prejudice against race, colour, creed or culture.

I acknowledge and accept that any fees / deposits paid with regards to this event are non-refundable. I further recognise that it is my responsibility to be appropriately licensed and insured at the time of my involvement at this event. I also recognise that passport / visa arrangements are my own responsibility. In addition, I accept that if any part of this form is incomplete…the organisers are at their discretion to either reject my application or make any alternative provisions they deem necessary to complete the event organisation / administration.

I accept that (by taking part in this event) it may be necessary for the Local Organizing Committee (or an appropriate delegated person) to obtain multimedia material for the its publications or media needs. I freely give my consent to partaking if such needs should arise. I acknowledge that no photographic, video or other media material of the event training content may be obtained by me without the prior written permission of the Local Organizing Committee.

Finally, I accept the above rules regarding events & agree to respect any decisions (in relation to the conduct of this event or myself) taken by either the Local Organizing Committee or any other person that the Local Organizing Committee may delegate authority to, before/during/after this event, as final.

I have used the online payment form to pay:


I agree to the declaration:

'Please note that no application will be processed without recipt of the necessary application fee'

For further details and or assistance please contact: events-officer@shotokaimeetings.com
 
 
 
 

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