1st Dan Black Belt Grading Junior Application

Student Name

Name of Parent

Student's Full Address

Please enter complete postal address as this is where the result will be delivered by post

Postcode

Date of Birth

Parent's Mobile Telephone Number

Club (eg Grantham)

Name Of Student's Instructor

Black Belt Course Date

Black Belt Course Instructor's Name

Brown Belt Grading Pass Date

My child has approval from his/her PMAS Instructor to attend the Black Belt Grading (this will be verified)

Yes (please proceed)

No (please contact your Instructor before submitting this application)

After submitting this application you will be transferred to the payment section.

1st Dan Black Belt Grading Fee £200

I wish to apply for a 1st Dan Black Belt grading.

I agree to abide by the rules of the grading.

I understand that if my child does not pass the grading my child will be entitled to retake the grading in six months' time for no additional charge.

By submitting this form I confirm that I am over 18 years old and understand all monies are non-refundable.

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