Name:(Last)___________________________ First:___________________ M Initial:_____

Address(Street):____________________________________ City:____________________

State:________ Zip Code:___________________ Country:__________________________

Date Of Birth: Month______ Day______ Year________ Phone: (______)_______________

Style And Rank:__________________ Date Of Rank: Month_____ Day_____ Year:_______

All fees are non-refundable. Fees must be in U.S. Funds in the form of a Money Order made payable to KMAI. Mail this application and fees to:

Participant agrees to take full responsibility for any injuries or medical conditions that might occur during summer camp training whatever kind or nature. Participant understands that a risk of injury does exist and voluntarily assumes such risk and attests that he/she is physically fit to participate in the Korean Martial Arts Summer Camp.

WAIVER: The International TaeKwon-Do Association and the Korean Martial Arts Institute and all members, officers and Camp participants are hereby released from any responsibility for injuries or medical conditions incurred during or as a result of the activities of the Summer Camp. I hereby register for admission to the Korean Martial Arts Summer Camp. I fully understand that there are no refunds for any fees. I certify that all information on this application and materials submitted are true and accurate to the best of my knowledge. I further certify that I am at least 18 years of age.


        ________________________________________     _________________________
                                           Applicant's Signature                                                                   Date

        ________________________________________     _________________________
                           Signature of parent or guardian if applicant                                                 Date
                                         is under 18 years of age.

Submit: Payment in the form of a Money Order or Certified Check. Make All Fees Payable To KMAI, In U.S. Funds.