Membership Application | Masters-Center BodySmart Wellness Hypnotherapy Philip Holder PhD Wing Chun Certification Marie Holder MD Psychiatry Medical Hypnotherapy Certification Medical

North American Wing Chun Association
Div. BodySmart Wellness LLC.

www.Masters-Center.com
www.WingChunCenter.com

Dear Wing Chun Kung Fu Enthusiast,
Thank you for becoming an NAWCA “Friends of the NAWCA" member. Membership is a is a great way to network and to obtain valuable information about this fascinating system of martial arts. Members also receive special discounts on many NAWCA sponsored events and on various training materials and equipment. See our website for membership policies and details.
We will mail you your new certificate upon receiving your application and membership fee. You will also benefit from our email newsletters as part of your membership.

Sincerely,

Dr. Philip Holder
Grandmaster

Membership Application Form
Select One*
- I Am Applying To Join For The First Time
- I Am Currently Or Have Been A Member And Am Renewing
Membership Choice*
- Save! Special Three-Year Discount For Only: $75.00
- One-Year: $35.00
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Daytime Phone*
Evening Phone
Email*
Please provide your martial arts experience (if any) Below

Save and Continue Later

Payment Method*
- Visa
- Mastercard
Name as it appears on card*
Credit Card #*
Exp. Date*
Security Code*
Billing Address of your credit card if different from above
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
I Authorize this charge to my card*
Signature
Club Disclaimer

This Club/Forum is for the purpose of disseminating educational information and to facilitate positive interaction and communication between its members as well as between members and Club/Forum administrators. This Club/Forum and it's promoters in no way accept any responsibility for the accuracy or content of communications done through this Club/Forum and/or its owners, promoters, management, staff and/or administrators. Further the owners and/or administrators accept no responsibility for the conduct or actions of any club member(s). In joining this Club/Forum the applicant and/or member holds harmless and indemnifies for himself/herself and for any heirs or assignees, BodySmart Wellness LLC., it's management, administrators, staff, volunteers and any associates from any damages, injury or any other loss, and agrees not to sue or pursue any action of any type against the afore mentioned. All members participate at their own risk.
Please attach a photo of yourself to be included in your file.
Accepted file types: jpg, gif, png, pdf.
NAWCA Office Use Only
Member Number

Effective:
Expires:
Type the letters you see into the box below and click ‘Submit'

Save and Continue Later