Please Complete The Form Below

Select your province and region:
Province:
---Western CapeGautengEastern CapeFree StateLimpopoKwazulu NatalNorthern CapeNorth West ProvinceMpumalangaUSSASAPS

Region:

Enter The Club Name

Enter The Instructors Name

Instructors current grade & date obtained (Attach copy of grading certificate)

Grading Certificate (Click below to upload)

E-MAIL & FAX NO.

Chief Instructor E-MAIL & FAX NO

CLUB STRUCTURE: Non –Profit Organization/ Profit Making/Private. (If NPO provide NPO registration number. If close corporation provide CC number attached certificate/ proof of registration, if any)

Below Digital Contract to be completed by Dojo Head

I hereby certify that the information given above is correct, and that my members and I will abide by the rules and regulations of Karate South Africa (KSA) as the governing body of Karate and World Karate Federation (WKF). Noncompliance with the said rules and regulation will result in my membership to the KSA being terminated and that I will not have any dual membership to other dissident group(s).
The annual prescribed membership fees must be deposited into the KSA account:
• Standard Bank
• Account Name: Karate South Africa
• Account Nr: 101 369 684 98
• Branch Code: 051001
• Branch: Kingsmead
• Ref no: AFF/DOJO NAME

I agree to and accept the above

Date Accepted: