Athlete Information
First Name
First name is required.
Last Name
Last name is required.
Gender
Male
Female
Gender is required.
Date of Birth (YYYY/MM/DD)
Date of birth is required.
Level/Rank
10 Kyu
9 Kyu
8 Kyu
7 Kyu
6 Kyu
5 Kyu
4 Kyu
3 Kyu
2 Kyu
1 Kyu
1 Dan
2 Dan
3 Dan
4 Dan
5 Dan
6 Dan
7 Dan
8 Dan
9 Dan
10 Dan
Level/Rank is required.
Email Address
Email address is required.
Address
Address is required.
City
City is required.
Province
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Québec
Saskatchewan
Yukon
Province is required.
Postal Code
Postal code is required.
Home Phone
Home phone is required.
Competition Info
Weight (kg) (Mandatory for Kumite) (Optional)
Weight (kg) (Mandatory for Kumite) is required.
Experience (years) (Optional)
Experience (years) is required.
Style (Kata Only)
Select One
Chito-Ryu
Goju-Ryu
Shito-Ryu
Shotokan
Uechi-Ryu
Wado-Ryu
Other
Style (Kata Only) is required.
Sensei
Sensei is required.
Events
Kata
Kumite
Kata/Kumite
Para Kata
Events is required.
Emergency Contact
First Name
First Name is required.
Last Name
Last Name is required.
Relationship (Optional)
Please Select One
Mother
Father
Grandparent
Aunt
Uncle
Sibling
Babysitter/Nanny
Spouse/Partner
Relationship is required.
Phone (Cell)
Phone (Cell) is required.
Phone (Home) (Optional)
Phone (Home) is required.
Alternate Email (Optional)
Alternate Email is required.
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe. (Optional)
Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe. is required.
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