Document ID: e25a641fcdf5881b8a206a3acf632fd1e77f386f
April 26, 2017
Signed On :

Program Guide Acknowledgment - Derek Berthold

The Program Guide contains important information about Texas Tang Soo Do San Antonio (TTSDSA), and I understand that I should consult the Master Instructor/Owner regarding any questions not answered in the guide.

Since the information and policies described herein are subject to change at any time, I acknowledge that revisions to the guide may occur. All such changes will generally be communicated through official notices, and I understand that revised information may supersede, modify, or eliminate existing policies. Only the Master Instructor/Owner of TTSDSA has the ability to adopt any revisions to the policies in this guide.

Furthermore, I understand that this guide is neither a contract nor a legally-binding agreement. I have had an opportunity to read the guide, and I understand that I may ask the Master Instructor any questions I might have concerning the guide. I accept the terms of the program guide. I also understand that it is my responsibility to comply with the policies contained in this guide, and any revisions made to it. I further agree that if I remain with TTSDSA following any modifications to the handbook, I thereby accept and agree to such changes.

I have received a copy of Texas Tang Soo Do San Antonio’s Program Guide on the date listed below. I understand that I am expected to read the entire guide. Additionally, I will sign a copy of this Acknowledgment of Receipt, retain one copy for myself, and return one copy to TTSDSA's representative listed below on the date specified. I understand that this form will be retained in my file.


Signed by Derek Berthold
Signed on: August 16, 2017

Signature Certificate
Document name: Program Guide Acknowledgment - Derek Berthold
Unique Document ID: e25a641fcdf5881b8a206a3acf632fd1e77f386f
Derek Berthold
Party ID: d2e9d6c2-4118-49ed-bb9d-2269d680111a
IP Address:
Security Level: E-mail
Digital Signature:
Digital Fingerprint Checksum
Timestamp Audit
2017-04-26 11:39:55 CDTProgram Guide Acknowledgment Uploaded by Master Patrick West - IP
2017-08-16 21:08:02 CDTSigner name Derek Berthold was changed to Derek Berthold by IP:
2017-08-16 21:08:02 CDTDocument signed by Derek Berthold - IP
2017-08-16 21:08:02 CDTThe document has been signed by all parties and is now closed.