Vancouver Seiyu Karate

VANCOUVER SEIYU KARATE

Early Bird Specials by June 30!

2025 Seiyu Karate Summer Camp Registration

(19 years old and over)

Name (first name and family name)

Age

Phone Number (Enter as 10 digits without any hyphens or brackets)

Gender

Address

IKON Membership Number (Type 000 if you have not received a card yet.)

Belt Level

Dojo

Emergency Contact Person Name

Emergency Contact Cell Phone Number

Food Allergies or Restrictions (Please list food allergies and restrictions if the student has any)

2025 Summer Camp T-Shirt Size

Small (Teens / Women)

Medium (Teens / Women / Men)

Large (Teens / Women / Men)

X-Large (Women / Men)

How to get to the camp

I will drive to the camp

I don’t have a vehicle and I need a ride

I don’t have a vehicle but I have already found a ride

Can you give other participants a ride to the camp? (Please take their luggage into consideration! You will also be responsible for their ride back from the camp.)

Yes

How many participants can you give rides to?

Do you consider yourself a light sleeper or a heavy sleeper? - Light sleeper: Snoring bothers you a lot. - Heavy sleeper: You can handle snoring to a certain extent.

I think I’m a light sleeper

I think I’m a heavy sleeper

I'm not sure

SEIYU KARATE GENERAL WAIVER AND FORM AND PHOTO & VIDEO RELEASE

Ages 19 and over

Nature of Activity: This general waiver will cover the Seiyu Karate Summer Camp Event of 2025

Date of Activity: August 15 - 17, 2025

Means of Transportation: Transportation is the responsibility of the student attending. There will be a number of Seiyu Members attending who may be able to assist with travel to and from this event.

Location of Activity: Loon Lake Lodge & Retreat Center, 14500 Silver Valley Road, Maple Ridge, British Columbia, V4R 2R3.

I have read and understood the camp rules and expectations listed on the website. https://www.fightingart.ca/registration-summercamp

I hereby give my permission to take part in the activity as outlined above, and hereby agree as well and sufficiently indemnify and save harmless Vancouver Seiyu Karate and keep Vancouver Seiyu Karate indemnified and harmless of any and all demands, actions, proceedings, liability claims, damages, together with the costs and sustained or alleged to have been sustained howsoever arising from the aforesaid activity provided. I hereby authorize Vancouver Seiyu Karate to use the image of me taken during the activity in its public relations and communication materials to promote Vancouver Seiyu Karate.

Participant's Name

Participant's Signature

Signature field is empty.

A physical paper waiver form

The camp committee will send you a PDF general waiver form by early August. You will be asked to print it out and submit it before the first day of the camp.

I understand and will do.

PAYMENT INSTRUCTIONS:

You will be brought to a Credit Card/PayPal payment page after you click the "Register"button below.

Pay via e-transfer: If you wish to pay through e-transfer, you can. Click the "Register" button to register for the event and you will be directed to a Paypal/Credit Card payment page. Close it and send your registration fee to vkk@shaw.ca via e-transfer to complete your registration.

Adults Summer Camp Registration Fees (tax included)

CA$298

User