GojushinRyu International Martial Arts Memberships

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Applicant Information

Your Image

First Name

last name

Personal Email

date of birth

Personal Number

Country

City/Town/Region

Province/State/District

Postal/Zip/Pin Code

Dojo Name

Instructor

Goju Shin Ryu International has my Permission to take my Photograph/video publicly to promote the practice. I understand that images/video may be used in the print brochure, website, and social media. I understand that no Royalty, fee, or other compensation shall become payable to me by reason of such use.

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choose Your Membership

LifeTime Membership ^$ 250

For the individual joining the association

GojushinRyu International Martial Arts

Annual Membership ^$ 75

Pay annually for the individual joining the association

GojushinRyu International Martial Arts

Please Answer This Qusetion

Your Gender?

Male

Female

Are You A previous member?^{(if renewing)}

Yes

Expiring Date^{(if renewing)}

Current Grade^{(Kyu or Dan grade)}

Your Experience?

Junior

Senior

Have You ever been Convicted On the Charge Of Violence?

Yes

Do you Have any type of permanent Injury or Disability?

Yes

Describe your previous violance charge?^{(if you Have)}

Describe your Injury or Disability?^{(if you Have)}

Previous Injury or Disabilty?

I clearly Understand that Practice of martial arts is entirely At my Risk

If accepted by the association , I undertake to abide by the rules and Article of the Goju ryo kyokai including any ammendents that maybe made during my period of membership

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Applicant Information

Please Answer This Qusetion