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The Ambler Area YMCA Goju-Ryu Karate dojo is affiliated with the Goju-Ryu Karate-Do Kyokai (GKK) organization. The GKK is the largest and one of the oldest Goju organizations in America. It has been operating since 1959, and has member clubs throughout the United State as well as in Canada and Europe. The highest authority in the GKK is Master Motoo Yamakura. He generally manages the operation of the organization and provides direction in the art of Goju-Ryu. The majority of the organizational functions are handled through the headquarters by the director and other officers. The organization is based in Toledo, Ohio. Date _______________________ Dojo _________________________________________________________ Full Name __________________________________________ Birth Date _____________ Sex ____________ Address ___________________________________________ City ___________________________________ State/Province ____________________ Postal/Zip Code ___________________ Phone __________________ ID/SS# __________________________ Health ___________________________________________________ Where Employed ____________________________________ Occupation _____________________________ I do hereby swear that the above statements are true and complete. I understand that according to the discretion of the instructor or the director my membership can be denied or affirmed. In consideration of my acceptance into membership, I agree to release, hold harmless and indemnify the organization, including but not limited to, officers, participating members and instructors, all clubs, organizations, and firms of any and all liability for bodily injuries, disease, or ill health, or the aggravation of such, decease, all claims, demands, cost, losses, and expenses, which I, my heirs, and personal representatives may have arising out of, or caused in any way by, or having any connection with my participation in school activities, training, contests, and practice, and/or the use of any and/or all facilities and materials owned, leased, or in the care or use, custody, or control of any of the above listed , including traveling to and from martial arts activities. If accepted, I agree to abide by the organization rules, regulations, and constitution, and to contribute to the goals of the Goju-Ryu Karate-Do Kyokai. In making application for membership I do so with the full knowledge that the techniques of maximum self-defense which, in part, comprise the art of Karate should be learned for use in self-improvement, competitive sport, or self-defense only. I swear unconditionally that I will never willfully harm anyone, except in defense of myself or another. If the need arises so to act, I will do so only so long as the attacker poses a real threat and will attempt to inflict no more injury than necessary to accomplish this end. Signed _____________________________________________ Date ___________________________ Co-signed __________________________________________ Date ___________________________ (if under 21 years of age) Instructor/Officer ____________________________________ Date ___________________________ - - - - - - - - - - - - - - - - For GKK Headquarters Use Only - - - - - - - - - - - - - - - - - - Date Recorded ____________________ Kyokai __________________ GKK Card Patch
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