Nikkei Karate Online Registration Form
Competitor Last Name
Competitor First Name
Address
City, State
Zip Code
Daytime Phone Number
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
Height
Sex
Weight
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 $25 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.com. Note: Your information is confidential and will not be released to anyone !
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 !
Japan Relief Donations accepted here! Go to our home page and select the button on the lower left marked: "Donate to Japan Relief"

Donations made fast and easy using Pay Pal and are tax deductible
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I have read and agree to the terms of the waiver and liability release