DOJO MEMBERSHIP APPLICATION

Mailing Address:   

DOJO ORGANIZATION

1334 Clairmont Dr.

Shelby, NC 28150

Phone: 704-487-1377 or 704-435-1050

E-Mail: dmtkd@bellsouth.net

 

 

DOJO MEMBERSHIP APPLICATION

***Please complete the entire application**

(We must have original signatures: Fill out, print and send in!.)

Fees: (Jan - April $ 45) (May - Aug $ 55) (Sept - Oct $ 65)

Membership Deadline: October 31, 2025

 

Name:                DOB:

 

Home Number:           Studio No:   

 

Address:            City:

State:             Zip:

 

What is the name of your studio?

What is your style?

 

Who is your instructor?

How long have you been in the martial arts?

 

What is your rank?       What is your favorite division? 

Did someone recruit you to join?                   Who?

 

Were you a Dojo member last year?  If so, what was your number

Waiver: I, the undersigned, hereby voluntarily submit my application for the attendance and participation of the "DOJO TOURNAMENT CIRCUIT." I do hereby assume full responsibility for any and all damages, injuries and losses that I may sustain or incur in any way while attending and participating.  I hereby waive all claims against the promoter's, staff members, individual sponsors and operators of the Dojo tournament circuit for any claims or injuries that I may sustain.  I understand that any pictures or video taping can be used for marketing and promoting the Dojo tournament circuit.

 

 

Signature of Member __________________________________________     Date ________________

 

Signature of Parent/Legal Guardian if under 18 _____________________________     Date _________