AMATEUR MARTIAL ASSOCIATION
20-21 Fernhill Mill, Hardman St, Bury, BL9 5BL

AMA MEMBERSHIP LICENCE INSURANCE
FOR ROI CLUB VENUE No.2
Kieran Fitzgerald

DOB: 19 December 1971
Style: Shotokan | Grade: 3rd Dan

License: s-insmyxps-2-roi
valid for 365 days from issue date: 21/08/2025
Club No.2: Seaview Celtic (R15511K/336208/A)
Club No.2 Address: Seaview celtic annestown
Annestown
Annestown, Waterford X91PW50

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INSTRUCTOR
Approved by Peter Allen for AMA UK on 21/08/2025 
IP: 2a02:8086:d0c:ee00:7c22:1d3b:951b:5227