Spring 2025 Kumite Seminar Registration

First name

Last name

Gender

Age

Email

Dojo

Belt Color

Membership Number

If you don't have one, type 000.

Height (cm)

Weight (kg)

Emergency Contact Person

Cell Phone Number of the Emergency Contact Person

Is this your first time attending?

Yes

No

Protective Gear

Check the ones you have.

Are you interested in experiencing controlled sparring matches during the seminar?

Yes, I would like to

I'm not sure. I think I'm a bit afraid.

Not this time

Required Payment

Kumite Seminar Registration Fee ($25.00 CAN)

Credit Card or PayPal:

You will be brought to a payment page after you submit this form. You can either pay with Credit Card or via PayPal.

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 payment page. Close it and send your registration fee to vkk@shaw.ca via e-transfer to complete your registration.

Acknowledgment of Agreement:

I have chosen to participate in the 2025 Spring Challenge Kumite Seminar and I understand there are risks involved in any physical activity. I, therefore, agree to not hold any sponsors, organizations, or individuals responsible should any injury of any nature occur while taking part in this tournament. Upon being accepted to participate in the tournament, I will obey all the rules and regulations governing said tournament. I agree that this registration may be canceled at any time. I acknowledge event photos will be taken and posted on social channels, and that I may be contacted with the information I provided.

I hereby authorize Vancouver Seiyu Karate to use the image of me taken during the class in its public relations and communication materials to promote Vancouver Seiyu Karate.

I agree

Your Signature (Parent/Guardian required if under 19 years old)

Your Name (Parent's or Guardian's if the Participant is under 19)

Seminar Fee

CA$25