I.K.F.
Ticket Technical
|
name |
Born city: |
date of birth |
Resident adderss |
n° |
City |
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|
|
dan |
date releases |
Federation |
Qualification |
date releases |
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|
|
Date begins karate |
Practiced
styluses |
possible titles |
|
|
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|
|
Tiket fiscal |
telephone |
E-mail |
Possibile situated |
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With the compilation
of the card, the subject Declares that the brought again data are truthful,
Declare besides, of authorize the I.K.F., in base to
the
law n° 675 of the 1996, to the treatment and has to hold the own personal data
in file.
City and date Signature