2019 Daiheigen Yudanshakai Summer Camp Registration Form
USJF Sanction #19-06-02
June 7th-10th, 2019
Boise State University

Early Registration Deadline: Wednesday, May 1st, 2019
Final Registration Deadline: Thursday, May 23rd, 2019

Email address *
***Please double check your email address is correct***
The email address provided will be used to communicate valuable camp information to you.
Participants First Name *
Your answer
Participants Last Name *
Your answer
Mailing Address *
Street, City, State Zip Code
Your answer
Phone Number *
(xxx-xxx-xxxx)
Your answer
Club/Dojo *
Your answer
Sex *
***Participants must be age 12 to 20 and orange belt or higher to register***
Participants outside this age and/or rank requirement must contact the project manager (Michael Eldred, mme@fmtc.com) before registering for the camp. (Judoka not meeting these criteria may be considered by the project manager but a priority will be given to participants who meet the criteria)
Age *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Belt Color *
Your answer
Weight (in pounds)
Your answer
Emergency Contact Name *
Full Name (first and last name)
Your answer
Emergency Contact Relationship *
Example: mother, father, wife, etc.
Your answer
Emergency Contact Phone Number *
(xxx-xxx-xxxx)
Your answer
T- Shirt Size *
Participant Type: *
After registration is complete, you will receive a payment request to pay for the camp fee through PayPal.
I understand that I will have to do the following to complete my registration: 1) Pay for the appropriate camp fees through the PayPal payment request that will be provided to me, 2) Provide a copy of my current judo membership card, and 3) Complete any additional forms provided to me by May 29th *
Required
Will you need transportation from/to the Boise Airport?
Transportation will be available from Boise airport to Boise State University on June 7th from 12pm-5pm and from Boise State University to the Airport on June 11 from 4:30am-12pm. Other times may be available, please contact Michael Eldred at mme@fmtc.com for more information.
If you are using housing on Campus, will you need a parking pass for a vehicle?
Parking permits are available for people staying on campus for $2.25 per day per vehicle.
If Assistance/Accommodation is needed (check off appropriate line):
Type of assistance/accommodation requested or name of person assisting:
Your answer
Dietary restrictions
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