Okinawan Goju-Ryu (Karate) and Kobudo Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * Country (###) ### #### Text? * Yes No Email * Date of Borth * MM DD YYYY Medical History * Previous martial arts training Please include style, rank obtained and instructor ASSUMPTION OF RISK * I have read and agree to the DESCRIPTION OF RISKS I have read and agree to the MEDICAL/HEALTH INSURANCE I have read and agree to the INFORMED CONSENT I have read and agree to the AUTHORIZATION TO REPRODUCE PHYSICAL LIKENESS I acknowledge that I have read and fully understand the agreement Thank you for submitting your registration. Registration Form Return to Programs Read in its entirety before submitting the formMinor Application Form and WaiverorAdult Application Form and Waiver