UNITED STATES CHUNG DO KWAN, INC.
Referee Certification Online Test

Step 1: Information
(This must be filled out and submitted for each participant, Step 2 is only done once)

NAME:
E-MAIL:
RANK:
SHIRT STYLE:
 Female    Male
SHIRT SIZE:
PHONE:
SCHOOL NAME:
ADDRESS:


I promise to be loyal and trustworthy to the USCDKA and my Instructor. I understand that I am engaged in a contact sport and agree to hold harmless the U.S Chung Do Kwan Association, Inc., its members, officers, instructors, masters, all schools, their officials, and All About Kids Sports, Inc. from all damages, costs, injuries, and expenses, however incurred during or as a result of my participation in the USCDKA Seminar.