10th KYORUGI & 03rd POOMSAE DISTRICT TAEKWONDO CHAMPIONSHIP 2024 - 2025

SUB JUNIOR, CADET, JUNIOR AND OPEN SENIOR MALE FEMALE

19th To 20th May 2024
VENUE: ALL SAINTS SCHOOL, MAU ROAD, KHANDARI, AGRA
KYORUGI INDIVIDUAL ENTRY FORM
BOYS SUB JUNIOR JUNIOR NON
FRESHER
GIRLS CADET SENIOR
FRESHER
PHOTO
NAME IN CAPITAL

PARENTS / GUARDIAN'S NAME

DATE OF BIRTH (DD/MM/YYYY)

AGE (AS ON 31.12.2024) IN YRS WEIGHT (IN KG)

SCHOOL

CLASS HEIGHT (IN CM)

ADDRESS

PRESENT BELT GRADE & CERTIFICATE No.

TFI ID - CARD No.

COPY OF CORPORATION / MUNICIPAL BIRTH CERTIFICATE & TFI I.D CARD SHOULD BE COMPULSORY.
(Original Birth Certificate & TFI ID-Card Should Be Produced At The Time of Weight - In)

DECLARATION
I the undersigned do hereby solemnly affirm, declare and confirm for myself, my heirs, executors &

administrators that I indemnify the Promoters / Organizer / Sponsors & its Members, Officials, Participants,

etc holding myself personally responsible for all damages, injuries of accidents, claims, demands, etc

waiving all prerogative rights, whatsoever related to the above set for the event.

Sign. of PARENT'S / Gaurdian Sign. of PRINCIPAL / COACH Sign. of PARTICIPANTS

With School Stamp
FOR OFFICE USE ONLY
1st CHANCE 2ND CHANCE 3RD CHANCE
WEIGHT - IN
 10th KYORUGI & 03rd POOMSAE DISTRICT TAEKWONDO CHAMPIONSHIP 2024 - 2025
SUB JUNIOR, CADET, JUNIOR AND OPEN SENIOR MALE FEMALE
19th To 20th May 2024
VENUE: ALL SAINTS SCHOOL, MAU ROAD, KHANDARI, AGRA
POOMSAE INDIVIDUAL ENTRY FORM
BOYS SUB JUNIOR JUNIOR FRESHER NON FRESHER
GIRLS CADET SENIOR INDIVIDUAL PAIR GROUP

NAME IN CAPITAL PHOTO

PARENTS / GUARDIAN'S NAME

DATE OF BIRTH (DD/MM/YYYY)

AGE (AS ON 31.12.2024) IN YRS
SCHOOL
CLASS

ADDRESS

PRESENT BELT GRADE & CERTIFICATE No.

TFI ID - CARD No.

COPY OF CORPORATION / MUNICIPAL BIRTH CERTIFICATE & TFI I.D CARD SHOULD BE COMPULSORY.
(Original Birth Certificate & TFI ID-Card Should Be Produced At The Time of Weight - In)

DECLARATION
I the undersigned do hereby solemnly affirm, declare and confirm for myself, my heirs, executors &
administrators that I indemnify the Promoters / Organizer / Sponsors & its Members, Officials, Participants,
etc holding myself personally responsible for all damages, injuries of accidents, claims, demands, etc
waiving all prerogative rights, whatsoever related to the above set for the event.

Sign. of PARENT'S / Gaurdian Sign. of PRINCIPAL / COACH Sign. of PARTICIPANTS

With School Stamp