Okinawa Uechi-ryu Family of Organizations (C)
POB 217
Mount Dora, FL 32756
Tel: 321-273-0409    Fax: 352-653-3132
Application form: for AFFILIATED ORGANIZATIONS
This form for e-mailing to Federation Headquarters

Members receive password to private "learning Center" website, monthly e-mail video clip instruction tips,reduced rate for rank certificates, as earned, from the IUKF, reduced rates at IUKF activities, Book, Video and product discounts. Dojo receive wholesale discounts on all products and activities
Name of Dojo:
Address
City:
State:
Postal Code:
Tel:
Fax:
Style:
Other Organization Affiliation:
Years in Martial Arts:
Please describe your Martial Art history, including names and rank of your instructors and styles studied:  
 
Registering: Organization ($50 per year)
Payment Method:
If you wish to pay by Master Card or Visa now, please fill out the following form:
Name on Credit Card:
Credit Card to be used:
Credit Card number:
Expiration date & Security code:

(Please note that G&S Consulting processes all credit card payments)

Paypal: request the information

All renewals are due on January 1st of each year. It is expected that all individual members of the affiliated dojo will become and maintian active individual membership in the Organization.

By applying for membership, I hereby fully and unconditionally release the IUKF , its Officers and Directors, Certified Instructors and Member dojo from any and all claims for any and all injuries, accidents or losses that I may receive while practicing the martial arts sanctioned by the IUKF.

Name of Organization Head applying for dojo membership: