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#NameAgeEmailPhone #DojoFederation
Current Rank
Participation in Seminar (28th)Participation in Shinsa (28th)Rank Applying ForParticipation in Takai (1st)Engi-Kyogi Event
Engi-kyogi Position
Engi-kyogi Partner
Individual ShiaiTeam Shiai?Team NameTeam PositionCertified ShinpanWill you be attending the 20th Anniversary Party (location TBD) for $50?Please list any medical conditionsEmergency ContactEmergency Contact #Payment MethodComment/Questions
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