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.
* Required
Email address
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Kendo Rank (None/_Kyu/_Dan)
*
Choose
None
6 Kyu
5 Kyu
4 Kyu
3 Kyu
2 Kyu
1 Kyu
1 Dan
2 Dan
3 Dan
4 Dan
5 Dan
6 Dan
7 Dan
8 Dan
Kendo Rank Achieved Date
MM
/
DD
/
YYYY
Iaido Rank (None/_Kyu/_Dan)
*
Choose
None / NA
6 Kyu
5 Kyu
4 Kyu
3 Kyu
2 Kyu
1 Kyu
1 Dan
2 Dan
3 Dan
4 Dan
5 Dan
6 Dan
7 Dan
8 Dan
Iaido Rank Achieved Date
MM
/
DD
/
YYYY
Date of Birth
*
MM
/
DD
/
YYYY
Gender
Male
Female
AUSKF # (if known)
Your answer
Phone #'s (cell, work, and home)
Your answer
Emergency Contact Name/Number/Email
*
Your answer
If you are below 18 years of age, enter Guardian Name, phone number, and email
Your answer
Home Address
Your answer
Liability Release Form Signed
*
Yes
No
Practice Location(s) select all that apply
*
Herndon Community Center
Spring Hill Rec
Dulles South
Required
Annual Fee, checks Payable to "Washinkan Corporation" or may be made via PayPal
Choose
Washinkan Member Adult (18+) $100 + AUSKF/GNE Registration $80 = $180
Washinkan Member Youth (under 18) $50 + AUSKF/GNE Registration $55 = $105
Washinkan Member Iaido Only $50 + AUSKF/GNE $55 = $105
Supporting Member (10 or less practices/yr) $25 + AUSKF/GNE Registration $55 = $80
Washinkan Member Full-time College Student $50 + AUSKF/GNE Registration $55 = $105
Other
Amount if "Other
Your answer
Additional Comments
Your answer
Submit
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