WASHINKAN REGISTRATION FORM
Washinkan / GNEUSKF / AUSKF Form
Dojo Members are required to register and pay dues annually for local (Washinkan), regional (GNEUSKF), and national (AUSKF) membership. Local dues cover events and costs that benefit local Washinkan members. Regional and national dues are required for members of local dojos and help cover costs of regional and national promotion (rank) testing, competition, educational seminars, and more.
Email address *
First Name *
Last Name *
Kendo Rank (None/_Kyu/_Dan) *
Kendo Rank Achieved Date
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DD
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YYYY
Iaido Rank (None/_Kyu/_Dan) *
Iaido Rank Achieved Date
MM
/
DD
/
YYYY
Date of Birth *
MM
/
DD
/
YYYY
Gender
Clear selection
AUSKF # (if known)
Phone #'s (cell, work, and home)
Emergency Contact Name/Number/Email *
If you are below 18 years of age, enter Guardian Name, phone number, and email
Home Address
Liability Release Form Signed *
Practice Location(s) select all that apply *
Required
Annual Fee, checks Payable to "Washinkan Corporation" or may be made via PayPal
Amount if "Other
Additional Comments
Submit
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