Name of Applicant:________________________________________ Sex: _______Age:______

Address:__________________________________________City:______________________State:______

Zip: ___________ Phone:___________________________

Present Dojo:___________________________________

Dojo Address:___________________________________________________

Sensei:____________________________________ Lineage:_____________________________

Karate Rank:_______________Style:________________________________

Kobudo Rank:___________________________

License:__________________________ Issued By:__________________________________

REMARKS:________________________________________________________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

__________________________________________________________________________________________________________

By applying for (KOBUDO) training, I hereby and unconditionally release the SKKF, its Officers and Director, Licensed Instructors, and Member Dojos from any and all claims for any and all injuries, accidents, or losses that I may receive while practicing the (KOBUDO ARTS) sponsored by this federation founded by Shihan Tyrone Wiggins Sr. Chief Instructor.


Signature of Applicant:_____________________________________________Date:______________

Date Approved by SKKF:_________________SKKF Membership No:_____________________