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an application form

Please use Netscape Navigator and write in english

name：

date of birth：

age：

nationality：

address：

height： inch or cm

weight： lbs or kg

telepone：

sex： male female

style of karate：

dan/kyu belt rank：

I swear to promise to obey the rules of your compitition and I also do dot require any responsibility to anyone if I am injoured or accident during the compitition.

※Please Send your photos( 2 pieces, 5cm×4cm ) until 　
　 with an application form.