Jeet Kune Do Association
Email_____________________________________________________(Please print clearly for JKD Newsletter.)
(style, rank, years of experience)(any JKD training)
I understand that I am enrolling in a martial arts training program which incorporates physical contact training, and by the nature of this program there is a possibility of injury. In case of my injury I agree to release Professor Gary Dill, Master Jill Hernandez, and any of his staff and / or instructors from any liabilities and claims that may result from such injuries. I agree to follow the rules and policies of the Jeet Kune Do Association and Self-Defense Systems International Martial Arts Federation. I understand that I will not be involved in any activity that will bring discredit or embarrassment to my school, instructor, or the JKD Association. I may terminate my training at any time I desire. My membership and training is considered “at will” and my membership and training may be terminated at any time by my instructor and/or the JKD Association. The information provided in this application is true and correct, and that this is my signature below (or my parent or guardian if a minor).
Professor Gary Dill, 1st Generation JKD Student, Oakland CA (Bruce Lee- Chief Instructor, James Lee-instructor)
Master Sifu Jill Hernandez, 2nd Generation Student, Executive Director - Jeet Kune Do Association
Prof. G.W. Dill
PO Box 3396
Bartlesville, OK 74006
Chief Sifu / Professor Gary Dill
Oakland to Oklahoma......49 years JKD experience (1971 - Present)
PLEASE COPY/PASTE AND PRINT THE APPLICATION FORM IN A WORD FORMAT, AND FILL IT OUT. (Shrink text to fit onto a single page, if necessary.)
YOU MAY EMAIL IT BACK WHEN COMPLETED, OR MAIL IT TO THE APPROPRIATE ADDRESS.
WE HOPE TO MEET YOU SOON!!!!