Nikkei Karate Online Registration Form
Competitor Last Name
Competitor First Name
E-Mail Address
Instructor Name
School Name
School Address
School City, State
School Zipcode
School Phone Number
School E-Mail
Age on tournament day
Years of Training 
Sex 
Kata Event Category
(Forms) i.e. K5
Kumite Event Category
(Sparring) i.e. S50
Step 1: Fill out form.
Step 2: Press "Submit Registration Now" button to send registration information
Step 3: Press "Buy Now" to Go to Pay Pal and send payment of $30 per person

Please fill out form completely. Online registration available ONLY if paying online using PayPal. PayPal accounts can be set up for free on the PayPal website at: www.paypal.comNote: Your information is confidential and will not be released to anyone ! NOTE: YOU CAN ALSO ENTER YOUR CREDIT CARD ON PAY PAL
PRE REGISTRATION DEADLINE BY MAIL IS MONDAY BEFORE THE TOURNAMENT ! FORMS MUST BE RECEIVED BY THE MONDAY. ONLINE REGISTRATION DEADLINE IS FRIDAY BEFORE THE TOURNAMENT.
Waiver and Liability Release Form - If under 18 to be read and agreed to by parent or legal guardian
Email address used for Pay Pal (used for verification)
Note: After the form is completed, press the button below marked "Submit Registration Now". You will then be directed to a webpage where you can pay using Pay Pal. Only Pay Pal is allowed for paying for Pre-Registration. The cost is free to set up an account and tie it to either a credit card or bank account. It is safe, secure, and free !
NOTE: If you are having problems submitting your registration, use Microsoft Internet Explorer. There have been reported problems when using Google Chrome, Firefox, or Safari.
STOP! Do not register unless you already have a Pay Pal account or have a credit card
BLACK BELTS
COMPETE FIRST !!! 
MaleFemale
I have read and agree to the terms of the waiver and liability release