PLEASE PRINT              
NAME ______________________________ AGE _______ PHONE (____)____________
FIRST LAST                
BELT COLOR _________________________ INSTRUCTOR____________________
Location you train ___________________________ City____________________
(Circle Your Event)   Senior Sparring   Jr. Sparring   Sr. Kata
IF YOU ARE LATE TO THE TOURNAMENT YOU WILL BE WELCOMED AS A SPECTATOR
NOTICE: FOR SAFETY REASONS A PARENT OR GAURDIAN MUST ATTEND WITH THEIR CHILD