Entry Application - Combat Wrestling

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日本コンバットレスリング協会
［東京事務局］〒169-0073
東京都新宿区百人町 2-22-16-214 号
T/F 03-3368-8488 [email protected]
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Entry Application
Surname:
Given name:
Country:
Nationality:
Passport Number
Passport Issuance Date：
Passport Expiatory Date：
Your Team：
Category (age)：
Category (weight /KG)：
Birth Date (YY/MM/DD)
Height (cm)：
Phone Number :
Email Address：
・ Martial Arts Experience:
___________________________________________
・ Your Achievements in Combat Wrestling Championships
・Your Achievements in Other Martial Arts Competitions
・Your Dan/Grade (in Judo and/or others)
※ If you come to Japan by air, please specify in detail your flights (to and from Japan)/ Arrival Date /
Departure Date / Arrival Airport Name (Tokyo Narita or Haneda Airports) and Departure Airport Name for
our convenience.
2016 JAPAN COMBAT WRESTLING ASSOCIACION
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*%
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日本コンバットレスリング協会
［東京事務局］〒169-0073
東京都新宿区百人町 2-22-16-214 号
T/F 03-3368-8488 [email protected]
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Written Oath
To:
Organization Committee of Asian Championships of Combat Wrestling2016
I, the undersigned, hereby agree to completely abide by the Competition Regulation, and also fully abide to
the instructions given by the organizer when I wrestle in every match in the 1st Asian Open Championship of
Combat Wrestling.
I hereby agree that all the publicity rights applied to this Asian Championship shall belong to the organizing
parties exclusively.
I also hereby agree that I shall indemnify all the organizing parties and their related parties from any
responsibilities for any inquiry or accident I may suffer as the result of my participation to this Championship.
Date：＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿
Name：＿＿＿＿＿＿＿＿＿＿＿＿＿＿＿
Signature：＿＿＿＿＿＿＿＿＿＿＿＿＿＿
2016 JAPAN COMBAT WRESTLING ASSOCIACION

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