International open Summer Gashuku Norfolk 2014

LONG BEACH CAMPSITE, HEMSBY, NORFOLK.

September 5th-7th (Fri - Sun) 

£70.00 inclusive of Campsite, Training, Swimming pool, Saturday BBQ & food, plus Sunday buffet.

 

Application form

(Please note that minimum age is 14 years)

 

Name_________________________   Age___________   D.O.B___________
Address_______________________________________________________
Phone no____________________   Mobile________________________ 
E-Mail______________________@_____________________
Organisation _______________  Dojo_________________

Grade______________  License no___________________

Vegetarian Yes/No______________ 

Gashuku Fee enclosed £_______________

 

READ THE FOLLOWING CAREFULLY - IT LIMITS OUR LIABILITY

I, the undersigned guest of the International Gashuku organisers, acknowledge that I am applying for instruction in a martial art involving strenuous exercise and personal body contact. I acknowledge that any insurance that the organisers may carry may not cover injury.  I do hereby hold the Schools, their instructors, employees, volunteers, and agents harmless from any and all liability (including legal fees and costs) for all claims, actions, or damages due to injuries suffered by me or caused to third parties by me, arising out of activities involving Karate and Gashuku events, or any variation thereof, whether occurring on the premises of the organisers or elsewhere, excepting only those claims, actions, or damages caused by the gross negligence or wilful misconduct.  I agree to abide by the rules of the organisers and to follow all instructions given by instructors during the course of this event.

Date __________________   Signature ___________________________________________

If student is under eighteen (18) years of age, parent or guardian must sign the following.

I, the undersigned, as parent or guardian of the above applicant, certify that I have read the above application and I consent to the applicant's receiving the instruction applied for and I agree to the provisions of the contract for myself and said applicant.

Date __________________   Signature ___________________________________________

 

Cheques payable to 'B Leigh' and send to: Sensei Kevin Leigh, 3 Diamond Road, Watford, Hertfordshire, WD24 5EN.

 (All fees non returnable).