MKKI National Gasshuku Registration

Participant Name

Participant Last Name

Address

City

State *

Zip Code

Country

Email

Cell Phone #

Work Phone #

Emergency Contact

Emergency Phone #

Illness/Injuries?

Karate Rank

Kobudo Rank

Dojo Name

Dojo Instructor

Instructor Member$485.00Adult$270.00Children$155.00Non-Member Additional$85.00

Saturday Dinner Qty:

$0.00

T-Shirt (S-XL):

$0.00

(*) Please contact us for larger sizes t-shirts

T-Shirt (2XL):

$0.00

PLEASE DONATE TO BUDO CENTER

How is my donation going to be used? Please click here

Donation:

$

25th ANNUAL MKKI NATIONAL GASSHUKU