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Seminar Registration
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Events
Seminar Registration
KAJ GOJU RYU KARATE-DO SRI LANKA
Seminar Registration Form
1. Seminar Details
Seminar Name *
Date
Venue
Chief / Guest Instructor
2. Participant Information
Full Name *
Date of Birth *
Age *
Gender *
Male
Female
Other
Nationality *
National ID / Passport No. (Optional)
Recent Photograph (Upload) *
JPEG or PNG format, max size 2MB.
3. Contact Information
Mobile Number *
Email Address *
Address *
4. Karate Information
Dojo / Branch *
Dompe Headquarters
Colombo Branch
Biyagama Branch
Pugoda Branch
Gampaha Branch
Current Grade (Kyu / Dan) *
Instructor's Name *
Membership Number (if applicable)
5. Seminar Category
Children's Seminar
Technical Seminar
Kata Seminar
Kumite Seminar
Black Belt Seminar
Instructor Development Programme
Referee & Judge Seminar
6. Emergency Contact
Name *
Relationship *
Contact Number *
7. Medical Information
Do you have any medical conditions? *
No
Yes
Please Specify Medical Conditions *
8. Declarations & Consents
Participant Declaration *
I hereby declare that the information provided above is true and accurate. I agree to comply with the rules, discipline, and etiquette of KAJ Goju Ryu Karate-Do Sri Lanka.
Parent / Guardian Consent (For participants under 18 years)
I, being the parent/guardian of the participant, hereby give my consent for them to register and participate in this technical seminar.
For Official Use Only
Registration Number
Payment Status
Approved By
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