Koshukai Registration Form
Email address
Step 1: Complete This Registration Form
Step 2: Complete Payment Options Below This Form
Koshukai Event Registration - Blackbelt Dinner - Sayonara Banquet
First and Last Name
Your answer
Age
T Shirt Size
Your Karate Rank?
Best Contact Phone Number
Your answer
Your Email Address
Your answer
Name of Your Sensei
Your answer
Areas of Interest
Required
Are You Interested in Kobudo Training?
What is your Kobudo Rank?
Your answer
Will You Be Testing For a Kobudo Blackbelt?
If Testing, What Degree Kobudo Blackbelt?
Will You Be Testing For a Karate Blackbelt?
If Testing, What Degree Karate Blackbelt?
Will You Need Child Care During the Sayonara Banquet?
If so, How Many Children?
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