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[{"$nulls":8},"日時 Date"]
[]
["他流派総本部道場受講申込書\nJKA HQ Dojo Training Application for Visitor"]
["私は、公益社団法人日本空手協会総本部道場の稽古への参加を申し込みます。\nI hereby apply to participate in karate practice at the Japan Karate Association Headquarters dojo."]
["I. 受講者情報　Personal Information"]
[]
["1. 名\n　　First Name"]
[]
["2. ミドル・ネーム\n　　Middle Name"]
[]
["3. 姓\n    Family Name"]
[]
["4. Country "]
[]
["5. 現住所\n　　Address"]
[]
["6. E-mail"]
[]
["7. 生年月日\n    Date of birth",{"$nulls":6},"年齢\nAge"]
[]
["8. 空手修行年数 \n　　No. of Months & Years\n     in Karate training",null,null,null,"Years",null,null,null,"Months"]
["9. 所属団体 \n　　Karate School"]
[]
["II. 受講申し込み　Training Entry Form"]
[]
["Please place small circle 〇 "]
[null,"1st","2nd","3rd","4th","5th","6th","7th","8th","9th","10th"]
["受講日　Training Date","/","/","/","/","/","/","/","/","/","/"]
["10:00～11:00\n(Sat 10:30～12:00)"]
["17:00～18:00"]
["18:15～19:15"]
["19:30～20:30"]
["受講料 Training Fee"]
["合計 Total Amount",{"$nulls":7},"現金\nCash","カード\nCredit Card","振込\nBank Transfer"]
[]
["  受講料　　　　　　 　　1クラス 3,000円",{"$nulls":4},"協会利用欄"]
["  Training Fee　　　　JPY 3,000 / Class"]
["　　＊レクリエーション保険 保険料含む"]
["　　　Including Sports insurance fee"]