I(UCI'fi}{C TAEI{I,VONDC rt SELII-j}EFINCI C}-T-jlj Ol lFl

&IEIVTB trR SXflP

I, app1.,

APFLIC

AT'tr

Oi{ F {}-I{- I
i', hetibli
ClLib (hercinalicr
e

whose paiticulars appcar l-'eli

iiri

nrernber-sitfu

citite fuiUng Taeh"vor:do & Se1f-Ilefence

.rllrd "ll'h.e

t.',")
Name: NB.iC:
A.ddress:

Date of Biiil-r Cilizenship:

Tal'

(Ofiice),

(P.esidence)

G1P)

I'1:ice of V'r'ORIi/ SCLIOOL: Cir'.is:

to r',,aive or indemnify and keep T'he Ciub ar:'1 iis Lrstructors ancl/ or ilielll'D.rs, "utr' r-.rir, ,11jr-t1,,'l .nrrrr.'l or othcrwisc thar mav arisc rs a rcsult oinr L'e;;tt i:t'..t-.'c ',' ,,1fisr"...'ise sufering i<tss il the corrsc o1'undeitaLing an;r acii','ify or course oirraiiiill:; o.'glLrl,u:cd L, ;r on :rehaif of The Ciub.

1-Ler-r,.1,.).'eglee

T-\-+^. 19. -_----i,,r

(Signature of Application)

FOE APPLICATION TNDER 18 YEARS OF AGE:have the paren/ gurr.lian ol parlicipating in the activiiir of T'he Club anci a;ret io lvaivi: c.,i ,,-iderunily and kee': indemnified The Club and its instructoi-s and/ or ircmbeis, agaitl:;l i:ti1' r.lrrii-'.rr, ji-, r clerni,ncl iti oihcrwise that may arise as a result of his/ hel inj..ry ancl,1 ot'loss cii.re Io an'i ilcti', :,1. ''rg,',' r:r:zeJ Ly or on hchal I'of The Club.
T

ilc

otijectiorrto mv

:ron,/ claughter

L/aLL!.*------_

TrSE ONLY:Llembership )'Io: l{e i'.trilurendaiion of Instructor: Approved by The Club: l-\ ^ +^. u4tt,

I::(jil *iiFI{]tr

(Signafuie of parc nli Stuar-r"lail)

Entrance Fee:

Monthly Fee; Membership Fee: Uniforr,r:

Receipt No:

mffffiffi+HtlnrH Persatuan Taekwondo Negeri Sarawak

ffi'r# * eq H l't
'i lan unecK

(!VTF)
I

Sarawak Taekwondo Association ff/TF)

Ja)0ti

chnical Chair'man Natiinal Examiner

iniernational Referee 7ih Dan tslacr Belt