Copy of Registration Form2

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Registration

Registration starts on April 20

Registration Form

Participant Last Name

Age as of July 18

Male

Female

Participant First Name

City, Province/State

Phone

Number of Years Training (if not Uechi Ryu)

Kobudo Rank (if applicable)

Name of Sensei

Click here for List of Ranks

Number of Years Training in Kobudo

PRICES

Click on thumbnail to see prices.

Desa & Rooke Students

Guest Dojos

EVENTS

I will purchase a package:

Kenyukai Sensei Package - $490

Black Belt Package - $425

Jr. Black Belt 12-15yrs Teen/Adult Brown & below - $320

Children’s Package (11yrs & under) - $210

If three or more family members are registering for one of the packages take 10% of the total.

I will be purchasing individual options and extra tickets as follows:

Training:

Karate Training

# Seminars

# Kobudo Seminar

Total for Training

Tournament:

I'm not competing

If competing answer all questions

Kata

Kumite (sparring)

Number of years training if under Black Belt

If competing in Kumite

Height (inches)

Weight (lbs)

ADD Kobudo+ Number of years training if under Black belt

ADD TOTAL BOX FOR TOURNAMENT

If a package is not your best option based on what you can attend, individual options may be purchased.

Click here for prices.

Karate Training

# of Seminars

Kobudo Seminar

ADD TOTAL BOX

SOCIALS

Koshukai Kickoff Picnic

#of Tickets

Black Belt Welcome Social

Black Belt Dinner

# of Tickets

Sayonara Banquet

# of Tickets

ADD TOTAL FOR SOCIALS

Do you have any dietary restrictions? (if applicable)

T-SHIRTS

T-shirt is included in all packages - if not purchasing a package or want more than one you can add it to your registration here.

ADD TOTAL BOX FOR T-SHIRTS

PAYMENT

Payment must be submitted via paypal or eTransfer within 24 hours of online registration OR mail or bring in cash or cheque payment in a timely manner.

Alternate Payment options/plans can be arranged in extenuating circumstances.

For those attending from outside Canada, if the payment options don't work for you please contact us to discuss.

If three or more immediate family members are registering for one of the PACKAGES, take 10% off the total. If family of 3 or more not purchasing a package please contact us to see if you qualify for a discount.

Total Amount Owing

I will pay by:

Cheque/Money order made out in Canadian Dollars to SPIRIT

Mail

In Person

eTransfer to Spiritofthenorth@shaw.ca

(Please indicate in the notes what/who payment is being made for)

Send Payment through Paypal to desapaypal@shaw.ca

Funds should be sent in Canadian dollars (click on wallet and currency exchange section). Service charge of $16 for fees under $425 and $25 for fees over $425 must be added to your payment.