IWSD Application

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	IWSD Association Membership Application Print and return your application to: IWSD Association Administrator P.O. Box 14435 East Providence, RI 02914
Last Name:		First Name:	Initial:
Street:		Apt. #:
City:		State:	Zip Code:
Country:
Home Phone:		Work Phone:
E-mail:
Occupation:		Date of birth:
Education Background:
Martial Arts Experience (number of years):
Style(s) of Martial Arts Studied:
	Rank in your school/system (if applicable):
	Your instructor's name(s):
Please enclose two (2) photographs. One of the photographs will be used for your IWSD Association Member I.D., the other one will be kept on file. The size of the photograph should include a front view of the applicant with the head fitting within a 1" X 1" box (similar to the size of the photograph on your driver's license). Please also enclose $60.00 U.S. for two (2) years of membership (if for any reason that your membership is not approved, it will be returned to you). Upon approval of your application you will receive: An IWSD Association Member I.D. (for identification and status (rank) indication. Your I.D. will also entitle you to attend "Free Workshops" given by IWSD Association Master Level Instructors. An IWSD Association Member Handbook An IWSD Association member T-shirt (pls indicate size here: ) We are pleased that you have decided to join the IWSD Association. The IWSD Association is a private club. Membership into the IWSD Association is at the discretion of the IWSD Association Guiding Council, based upon the applicant’s physical and mental fitness, the desire to learn and the willingness to follow the IWSD Association rules. By acknowledging and signing this application, you understand the risk involved and agree to follow the terms and conditions required by the IWSD Association, while participating in any IWSD Association related activity. Members assume full responsibility for their conduct and are not to make any false representation of the IWSD Association. You the undersigned, and or guardian thereof, releases the IWSD Association, it's officers, employees, instructors, and coaches from all liability for any and all damages and injuries suffered or sustained while attending any IWSD Association related activity, while under the instruction, supervision or control of the IWSD Association, it's members, or its employees. You also certify that the information above is true and correct, and authorizes the IWSD Association to check the information for accuracy.
Applicant's Signature:			Date:
Parent or Legal Guardian's Signature (if under 18 years):			Date:

Copyright International Wushu Sanshoudao Association (IWSD), 2001 Revised: January ,(, /),(.

Copyright International Wushu Sanshoudao Association (IWSD), 2001
Revised: January ,(, /),(.