USA Karate Federation Rank Registration, Certification or Promotion

Rank Registration, Certification and Promotion Application
by The USA Karate Federation - USAKF
USA Karate Website.

USA Karate Federation provides for Registration, Certification of Promotion in the martial arts. 

Registration is simply a registration of the rank issued by your dojo organization. Certification requires that we verify your rank and your references and we will then issue a USA Karate Federation Dan Certificate at your current rank. Should you apply for promotion, then we will arrange for consideration of your application through our various resources around the world. 

The cost for each varies so you need to carefully complete the below application.
 
This is not for registration, promotion or certification in the USA National Karatedo Federation (USANKF.)



Registration Deadline: December 31, 2015 11:00pm [Eastern Time]


INFO:   Please note that this form contains limited capacity items which are sold out. They are displayed grayed out and are not selectable.

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Registrant Fee: $0.00

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First Name:
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Billing and payment processing for Businesses' events is performed by Member Solutions, Inc. ("MSI"), and this contract is specifically assigned to MSI for all such purposes. Customer knowingly and irrevocably authorizes MSI to charge electronically Customer's bank account and/or credit card for any and all amounts due for Customer's, and anyone registering under Customer's, attendance and participation in the Event. The phrase "8882448044 ONLINE REG FEE" will appear on your bank or credit card statement. Any returned payment will be assessed a $25.00 fee. Any unsuccessful electronic transaction is subject to a $10.00 processing fee. MSI is not responsible for any bank fees incurred by Customer. MSI has the sole right to resubmit returned or declined items (plus applicable fees) without prior notice. BILLING INQUIRIES -- 888-244-8044 or by mail to PO Box 297, Hatboro, PA 19040.

Applicant Agreement
I represent that I am the person who appears on the application above. I acknowledge and agree to the statements, terms and conditions above, as well as any applicable terms and conditions for this registration, and that by typing my name below and completing this registration form, I am electronically signing the document, which will have the same legal effect as the execution of the document by a written signature and shall be valid evidence of my intent and agreement to be bound.

Applicant Signature
Please enter your full name in the space below.
 


Please click the button below to finalize your registration.



Registration inqueries:
USA Karate Federation National Office
1550 Ritchie Road
Stow, Ohio 44224


or email USA Karate.
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First Name
Last Name
Title
Address
Address (line 2)
City
State
Zip
Country
Home Phone
Mobile Phone
Email
Gender
This application is for:
Registration is for registering your rank with USA Karate. For USA Karate Certification or Promotion an additional fee is charged for the additional work involved in issuing such credentials.
Rank Applied For:
Requested Effective Date of Credentials
Personal History
Date of Birth
Age
Occupation/Position
Highest Educational Degree
School/College where received
Karate Resume and History
Age at inception of Martial Arts Training
Month and Year Training Began
Current Martial Arts Instructor or who authorized your rank.
Address of Current Dojo Where Training
Style of Martial Arts
Current Rank
Date Received
For Dan Certification, please list each each Dan level, date received and person/organization giving the rank.
Please describe other Certifications received, date, and person/organization granting the credentials. For example, referee, first aid, ACMA, ASEP.
References
Name and Contact Information of Three References
Terms
Waiver and Release
By voluntarily agreeing to these terms I, the undersigned, state I have read the below waiver and release, understand that I have given up for myself and/or my minor child substantial rights by agreeing to the terms and conditions.

In consideration of participating in any way in any USA Karate athletics/sports program, and related events and activities, and training, the undersigned:
1. Agrees that prior to participating, they will inspect the facilities and equipment to be used, and if they believe anything is unsafe, they will immediately advise their coach or supervisor or USA Karate personnel of such conditions) and refuse to participate.
2. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions or negligence but the actions, inactions or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.
3. Assume all the foregoing risks and accept personal responsibility for the damages following such injury, permanent disability or death.
4. Release, waive, discharge and covenant not to sue The USA Karate Federation, its affiliated
clubs, regional sports organizations, their respective administrators, directors, agents,
consultants, coaches, and other employees of the organization, other participants, sponsoring
agencies, sponsors, advertisers, and, if applicable, owners and lessees of premises used to
conduct the event, all of which are hereinafter referred to as "releasees" from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury including death or damage to property, caused or alleged
to be caused in whole or in part by the negligence of the releasee or otherwise.

Personal Certification
In addition to the above waiver and release of liabiltiy, under penalty of expulsion and removal or credentials received, I hereby confirm that the above facts are a true and accurate presentation of my martial arts history and background. I fully understand that I can be expelled and have any certification or recognition withdrawn in the event of misrepresentation or fraud.
Check this box to indicate that you have read and agree to all of the above terms & conditions
I acknowledge that I am applying for registration, certification, or promotion in The USA Karate Federation and not the USA National Karate-do Federation and that a full refund may not be available should I register in error. By checking this box I accept these additional terms and conditions.
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