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WPO Affiliation Form

All material should be sent by mail to the general secretary office at:

World Pankration Organization
6 Hamanof St.
Rehovot 76386
Israel
What are you interested in? Please check with an "x"

Membership as an individual -
Club Membership -
Rank/Belt reassuring -
Belt examination -
Instructor certificate:
Reassuring new qualification
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Examiner certificate -



Please supply more details:
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I hereby declare that I understand that the WPO has no responsibility what so ever for any injury, illness, damage or loss, which may accrue to me, my students or third party due to my involvement in Pankration and/or martial arts.
Furthermore, I oblige to rmove all suite, demand ar complaint that will be directed to the WPO due to my work, actions, negligence, or non action, and take upon myself any expenses and/or damages which will be directed to the WPO.
I hereby declare that I will operate according to the laws and regulations, which govern Pankration activity in my country, and follow the WPo guidelines, policy and conditions.

Name:______________________ Signature:_________________ Date:________________