Online Registration for East Central Johnson Memorial Tournament
This form is replacing the paper registration form from previous years. Please fill out completely for each participant. Entries submitted after September 22, 2017 may not be accepted. If you have any questions, please contact Hiroko Matsuyama (hxm107@case.edu) or Jyoshu Tsushima (tsushimaj@gmail.com).
Email address *
First Name *
Your answer
Last Name *
Your answer
Age *
Your answer
Gender *
Phone Number *
Your answer
Address (Street, City, State, ZIP) *
Your answer
Rank *
Dojo Name *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Medical Conditions
Your answer
Individual Division *
Select all that apply. Divisions are subject to change based on the number of participants.
Women's Individual? (13 and up) *
Team Division *
Number of bento lunch boxes for Saturday *
$10 each, payment due with tournament entry fee
Your answer
How many people will attend the Saturday dinner party? *
7:00 pm at Miller's Ale House, 1201 Olentangy River Road, Columbus, OH 43212
Your answer
I acknowledge that the purpose of this form is for the preparation of the 2017 ECUSKF Johnson Cup. Before the participant named in this form is confirmed for the 2017 ECUSKF Johnson Cup, a waiver of liability signed by participant or legal guardian, a $35 participation fee, and all bento fees must be received by Jyoshu Tsushima at the address below. *
Required
Make all check payable to "East Central United States Kendo Federation"
All payments and liability waivers must be sent to:

Jyoshu Tsushima
66 S. Grant Avenue Apt #3
Columbus, OH 43215

All items must be submitted and postmarked by September 22. No entries will be accepted after this date. Please contact Jyoshu or Hiroko (email above) if you have any questions.

A copy of your responses will be emailed to the address you provided.
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This form was created inside of Case Western Reserve University.