BEMEMBER | Koei-Kan Tournament

New Account

Registration Step One - Create Your Account. Creating an account allows you to return to complete your registration, at a later date or change it if necessary. It also allows you to more quickly register for future tournaments. Fields marked * are required. If you would like to receive printed mailings for future events please complete the Address portion of the form by pressing the Mailing Address button. If you have already started your Registration and would like to complete or modify it, CLICK HERE

PERSONAL INFORMATION

First Name*

Last Name*

Phone No.*

Email Address*

Date of Birth*

Gender*

Male Female

Current Weight*

lbs

Current Height*

feet

inches

Create Username*

Create Password*

Re-Enter Password*

Emergency Contact*

Emergency Contact Phone No.*

Address

Apt / Suite / Floor No.

Country

State

Province

City

Zip

TRAINING INFORMATION

Current Training Level*

Kyu / Dan Rank*

Sensei's Last Name*

School / Dojo Name*

Country

State

Province

City

CONTACT INFORMATION

Periodically we send e-mails to inform members of karate related events. Please indicate if you would like to be included in these mailings.

Yes, please e-mail me with upcoming event info.
No, I do not wish to be included in your e-mails.

I, the undersigned do hereby voluntarily submit my application for attendance and participation in the International Koei-Kan Karate-Do Championship at St. Elizabeth University in Morristown, NJ and do hereby assume full responsibility for any and all damages, injuries, or bruises that I may sustain or incur in any way while attending or participating. I understand that karate is a very dangerous martial art, involving forceful physical contact that is likely to incite aggressive behavior that is beyond the control of the Koei-Kan Karate-Do USA family, that severe injuries or death may result from my participation in the activities of this martial art, and I fully and knowingly accept these risks and hereby waive all claims against The Sisters of Charity of Saint Elizabeth, Saint Elizabeth University in Morristown, NJ, its trustees, officers, members and employees, the Koei-Kan Karate-Do USA family, the promoters, operators, sponsors or volunteers of said tournament individually or otherwise for injuries I may sustain, knowing fully the risks involved in karate competitions. I certify that I have no injuries or physical disabilities and am in good health. Further, I agree that in the course of competing, photographs and/or audio and/or visual recordings may be made of all participants and spectators and that the use of these recordings is at the discretion of the Koei-Kan Karate-Do USA family to promote this and future events, as well as karate in general; further, I agree to accept no compensation for the use of my likeness in any future promotion. I also agree NOT to post kata video of myself or any other Koei-Kan competitor on YouTube or any other internet sites without the permission from the Koei-Kan Governing Board.

Write your name to digitally sign:
(If under 18 years of age, Signature of Parent or Guardian)

Click SAVE to proceed to next step. Click RESET if you would like to delete all your changes.