Wado Ryu Kenshu Kai karate Federation Of India
Approved by Karate Association of India , Asian karate federation,World karate federation
& Govt. Of India (Ministry of Youth affairs and Sports) World Karate Federation
(Recognized by International Olympic Committee).
Grand master
Yoshihiko Iwasaki
Chief Instructor India
th
Balvinder singh 6 Dan
India Head Office
222/31 Idgah road Model town Panipat,Haryana,132103,India
Website: -www.wadokarateindia.in
APPLICATION FORM FOR ADMISSION TO KARATE CLASS
Name of the applicant ________________________________________________________________
Occupation ___________________________ Date of Joining __________________________
Paste recent
Passport Size
Photograph.
Address _____________________________________________________________________________
Tel. No. (Resi) ___________________ (Office) __________________ (Mobile) _________________
Date of birth ____________________________________ Blood Group ______________________
Father’s Name _________________________________ Occupation_________________________
Office Address______________________________________________________________________
Office telephone No._________________________ Mobile Phone____________________________
Do you have any police record if yes give detail____________________________________________?
Do you suffer any ailment? _____________________________________________________________
RULES & REGULATIONS
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Association / instructor will not be held responsible in case of any injury during the course of karate learning.
Student must wear proper karate uniform during the course of karate practice.
Student must follow the rules and regulations of the Wado Ryu Kenshu Kai Karate federation of Indiaand instructions of its Chief
instructor Balvinder Singh – Black Belt 6th Dan.
Students must deposit their dues in time, if any.
Students are allowed to teach karate skills without the permission of chief instructor.
Place_____________
Date________________
Signature of parent / guardian (in case of minor)
Signature of applicant
_______________________________________________________________________________
For Official Use
Signature of Dojo Instructor
Registration number___________________________
Dojo_________________________

Bus Timing - Tezpur University

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