BRITISH WADOKAI KARATE-DO FEDERATION
英国和道会空手道連盟 - 本部道場
LICENCE/MEMBERSHIP APPLICATION
All members must hold an up-to-date British Wadokai Licence/Record Book.
PLEASE PRINT CLEARLY IN CAPITAL LETTERS WITH BLACK INK
Forename - Surname
Name [ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ]
Full Address [ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ] [ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ]
[ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ][ ]
Post Code ______Tel. No. ______****Email ______
Date of Birth __/__/__ Present Grade ___ Kyū/Dan. Club ______
Full start date if new licence ___/___/______
TYPE OF LICENCE (please tick in box & delete where required*)
New: *Student/Instructor British Wadokai Licence. [ ] £30.00
Renewal: *Student/Instructor British Wadokai Licence. [ ] £25.00
*Cheque/BACS.* IMPORTANT – See *Reference Below
If Renewal: BWK 5-digit Licence No. ______Expiry Date ___/___/____
Family Unit.** [ ] £65.00
Replacement. *** [ ] £5.75
*IF BACS PAYMENT: Please Enter BACS Reference: ______
Have you ever had a criminal conviction? YES/NO.* If YES we will contact you for details.
Do you accept that the practise of a combat-art or contact-sport involves the risk of serious injury? YES/NO.*
Do you suffer from any medical condition/s? YES/NO.* If YES, please indicate which applies. EPILEPSY, HAEMOPHILIA, HEART DISORDERS, HIV/AIDS, RESPIRATORY PROBLEMS, DIABETES, NERVOUS DISORDERS, OTHER/S: ______
If you suffer from any medical condition, it is important to ensure that your instructor is aware of these. It is also advised that ALL applicants (especially over the age of 40) should have a Medical Examination BEFORE commencing into any physical activity related to the Martial-arts.
I have read understood the BWK Rules & Regulations, Dojo Rules and Training Conditions:
INCLUDE WITH APPLICATION
1. Remittance. Cheque/Postal Order Payable to British Wadokai.
2. 2 Passport sized photographs. Not required if renewal.
DO NOT SEND YOUR IWF GRADE RECORD BOOK TO THE LICENCE OFFICE FOR RENEWAL
YOU ARE NOT A MEMBER OR INSURED TO TRAIN, INSTRUCT, ATTEND COURSES, GRADE OR COMPETE IF YOU DO NOT POSSESS A VALID UP-TO-DATE LICENCE
Applicant Signature ______Date __/__/____
(Parent/Guardian if under the age of 18 years)
Instructor Signature ______Date __/__/____
(Instructor/Secretary)
Keep Licence with you, at all times, whilst at the Dojo.
Send completed form to: British Wadokai. 57 South Hill, Hooe, Plymouth, Devon. PL9 9PT. BWK reserves the right to refuse an application without giving a reason.
Allow 14 days for processing.
THIS IS A TWO PAGE APPLICATION FORM - PLEASE SEE OVER FOR SPECIAL CONDITIONS
IMPORTANT INFORMATION & CONDITIONS - PLEASE READ CAREFULLY BEFORE APPLYING
IT IS YOUR RESPONSIBILITY TO HAVE A VALID LICENCE-MEMBERSHIP & INSURANCE AT ALL TIMES - IT IS ALSO YOUR RESPONSIBILITY TO ENSURE THE LICENCE APPLICATION FORM IS FULLY COMPLETED AND SENT DIRECTLY TO THE LICENCE OFFICE.
INCOMPLETE APPLICATIONS WILL BE REJECTED AND RETURNED
* Please delete where appropriate.
New Licences - Check postage-weight with the Post Office BEFORE sending. A new Licence/Membership will commence from the date application is received by the IWF Licence Office. You will require 2 passport-style photographs for all NEW BRITISH WADOKAI Licences.
*BACS Payments. *Enter BACS Payment Reference Above.
Bank: HSBC. Account Name: British Wadokai. Sort Code: 40-36-25. Account: 51421700.
International Transaction Details: IBAN No.: GB98MIDL40362551421700. Swift No.: MIDLGB2149F.
Important: Please email/send receipt or proof of payment to
**Family Members are discounted for 3 or more closed family units (immediate family (parents & siblings) at the same address) and does not include distant relatives, aunts, uncles, cousins, etc. Family members must apply together on separate Licence Application Forms. Once a family has been issued with a ‘Family Licence Facility’ more family members can be added later, if required, without extra cost!
Insurances - Public Liability & Person to Person Liability Insurances within a British Wadokai Licence is for all traditional Wadoryu training and related activities organised by British Wadokai and the British Wado Federation. Cover does not include training outside of British Wado Kai/Federation. Students are also uninsured to train in Sport Karate, MMA, kick-boxing, training with, or use of live bladed weapons etc. An Instructor who allows, promotes, encourages, or has knowledge of any of his membership involved within these ‘inadequately insured’ activities, will be considered ‘Negligent & Liable’. If unsure, please contact Katasure Insurance.
For UK Personal Accident Cover, and/or Freelance Instructor Insurance Cover, please contact: Katasure Insurance, Kinder House, Lombard Street, West Bromwich. B70 8SD. T 0845-4505020. E
Renewals – RENEW BEFORE EXPIRY. Licence Insurance & Membership will CEASE immediately upon expiry DO NOT send your BWK Licence/Grade Book to the Licence Office.
Applications from other organisations - Depending on origination (origin of style, certification, lineage, etc.) grades registered within your previous karate licence may be 'automatically' transferred [as honorary status] to your new BWK Licence upon acceptance, if desired. If you wish for ‘grade transfer’, please include a scan/copy of your previous Licence and/or certificate for British Wadokai records. Your Instructor will continue your grade commencement once you are in receipt of your new licence (stamped with your present grade) and are fully conversant with the requirements for progression. Apply as New Licence. THIS MUST BE YOUR ONLY KARATE LICENCE – YOU CANNOT DOUBLE-LICENCE (please refer to the BWK Rules & Regulations).
Late Renewals – Firstly: It is the sole responsibility of the individual to keep their insurance, licence, and membership up to date and valid. Secondly: It is considered 'negligent' for an instructor to allow students to train without adequate insurance. You are placing yourself and your instructor at risk of ‘negligent liability’ by training without insurance.
Due to the turnover of student memberships in martial-arts it is usually considered that if a martial-arts licence has expired it is normally due to the result of the individual terminating training & membership etc. A student who allows his/her licence to expire will result in the following: 1. Registration card is destroyed immediately. 2. Kyu grade registration records destroyed. 3. Insurance cover becomes invalid immediately at time of expiry. 4. Membership terminated at time of expiry.
All licences, memberships, grades will be immediately cancelled upon expiry. It will be up to the Leading Club Instructor to reinstate any grades lost, due to expiry, through application of a new BWK Licence/Registration. Only the latest grade will be reinstated on the BWK Registration Card as all previous records would have been destroyed.
***Replacement Licence Books - To replace a Licence Book, which has been lost or damaged, you must use this form. Replacement Licence Books are charged at £5.75 each payable to British Wadokai. Your recent ‘registered’ grade will be stamped onto the replacement Licence Book. If you require a replacement licence as part of your renewal, please apply as ‘New Licence’ (@ £30).
**** Email Address – By supplying your email address you are entering into an agreement that you would like to receive British Wadokai related information, such as Weekly Date Sections and Monthly Wado News! If you do not wish to receive this information, please let us know and we shall remove your email address from our database. If you wish to view our Privacy Statement details, etc., please go to; www.wadokai.co.uk/disclaimer.html
Insurance.
United Kingdom National Benefits Insured: General Third Party Indemnity, Public Liability and Member to Member Liability; £10m. For Full Synopsis, please refer to Master Policy. BWK Insurance Covers all ages.
A British Wadokai Licence includes: 1. Registration & Membership to British Wadokai/International Wado Federation. 2. UK Person to Person and Public Liability Insurance £10m. 3. Personal grade record log. 4. Personal injury log. 5. Includes Instructor Insurance, if applied/indicated, £5m.
CONFIDENTIALITY: ALL INFORMATION RECEIVED WILL BE FOR OFFICE USE ONLY
Updated 25/05/2018