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                                                        A.S.D JEET KUNE DO SHUI                                                                   

 

Modulo di adesione Stage Internazionale Original Jeet Kune Do

11/12 novembre

 

Nome …………………………………………………Cognome………………………………………………………...Data di nascita………………………..

Residente ……………………………………................................. Disciplina praticata………………………………Grado………………………..

Ente di promozione /Federazione appartenenza………….……………………………………….

Email……………………………………………….