Black Belt Promotion Test | Referee and Board Breaking Seminar & Written Test Registration

Referee Seminar and Written Test Information

Date: Saturday, October 15, 2022
Time: 2:30 PM - 4:00 PM (Including written exam)
Registration Deadline: October 1st, 2022 (Complete Regstration form including payment if applicable)
Registration Fee: Included in the black belt test ($50 plus GST if re-test)

Board Breaking Seminar Information

Date: Saturday, October 15, 2022
Time: 4:00 PM - 6:00 PM
Registration Deadline: October 1st, 2022 (Complete Regstration form including payment if applicable)
Registration Fee: $50.00 plus GST (5 Boards included)

Test Applicant Information

First
Last
Address
Street Address
Apt./Building/Suite #
City
State/Province
Zip/Postal
Country
Black Belt Referee Written Test

Board Breaking Seminar

5 boards included. For additional boards purchase, please contact our school for the arrangement.

Emergency Contact Information

Emergency Contact Name
Emergency Contact Name
First
Last

Waiver Information

I hereby give permission for myself/my child to participate in Jeon Eui Taekwondo Black Belt Promotion Test - Referee and Board Breaking Seminar and Referee Written Test. I understand that there is no refund on the above seminars and test. For extenuating circumstances, the above seminars and test may be postponed by providing written notice within 48 hours after the test. Only one postponement will be allowed and it must be re-scheduled within one year. Having read and understood all the information on this form, I hereby allow myself/my child to attend the referee and board breaking seminars and referee written test. The Waiver Forms that I have signed at Jeon Eui Taekwondo will also apply to the Black Belt Promotion Test - Referee Seminar and Written Test.

Sign by parent or legal guardian if under 19 years of age

Payment Total