I.K.F.
Ticket Coach
|
name |
Born
city: |
date
of birth |
Resident
adderss |
n° |
City |
|
|
|
|
|
|
|
|
dan |
date
releases |
Federation |
Qualification |
date
releases |
|
|
|
|
|
|
|
Date
begins karate |
Practiced styluses |
Coach dell'Athlete |
|
|
|
|
|
Tiket
fiscal |
telephone |
E-mail |
Possibile
situated |
|
|
|
|
|
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