KUGB Licence Application

Email:

Your Details

Surname:
Forename(s):
Address:
City:
Postcode:
Gender:
Date of Birth:
Just type your DOB in format dd/mm/yyyy

Type of Licence Required

Junior Licence (u16)
New
Renewal
£24
Senior Licence (16+)
New
Renewal
£27
Lost record book & licence slip
New
£4
Lost licence slip only
New
£2

Licences will be renewed from previous expiry date. If you have had a break in training, please tick box and give reason with re-start date on rear of this form

New members MUST give EXACT date they started training with the KUGB
Previous KUGB Licence Number (If any)
Previous Licence Expiry Date

Rank / DoJo

Please state the EXACT grade :
 
Kyu :
 
Dan :
Tick here if grade is non-KUGB
Name of club (please check with club instructor or secretary)

I undertake to abide by the Constitution and Rules of the KUGB (a copy of which is held by Club Secretaries or available at www.kugb.org) together with any amendments that may be made during the period of membership. I am aware that Karate is a strenuous activity and that it is the responsibility of Applicants (or their parents/guardians*) to ensure that they are medically fit to participate. The KUGB reserves the right to refuse an application.
 
The details you supplied will only be used by the KUGB and will not be shared with any third parties