| Competitor Information |
| Name: |
Male/Female: |
Email Address: |
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Competitor's name is required. |
Please select the Competitor's sex. |
Competitor's email is required.Invalid format. |
| Address: |
City: |
State: Zip Code: |
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Competitor's Address is required. |
Competitor's City is required. |
Competitor's State is required.
Competitor's Zip Code is required.
Invalid format. |
| Age: DOB (MM/DD/YY): |
Telephone # (404) 555-1212: |
Rank: |
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Competitor's Age is required.
Competitor's Date of Birth is required. |
Competitor's Telephone Number is required.Invalid format. (404) 555-1212 |
Please select the Competitor's Rank. |
| Karate School Information |
| Karate School: |
Instructor: |
School Telephone # (404) 555-1212: |
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Competitor's Karate School is required. |
Competitor's Instructor is required. |
Competitor's Karate School Telephone Number is required.Invalid format. (404) 555-1212 |
| Address: |
City: |
State: Zip Code: |
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Competitor's Karate School Address is required. |
Competitor's Karate School City is required. |
Competitor's Karate School State is required.
Competitor's Karate School Zip Code is required.Invalid format. |
| Youth Black Belt Divisions |
| Youth Forms: |
Youth Weapons: |
Youth Sparring: |
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| Youth Musical Forms: |
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Youth Musical Weapons: |
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| Adult Black Belt Divisions |
| Adult Forms: |
Adult Weapons: |
Adult Sparring: |
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| Adult Musical Forms: |
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Adult Musical Weapons: |
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| Youth Under Belt Divisions |
| Youth Forms: |
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Youth Weapons: |
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| Youth Sparring Boys & Girls: |
Youth Sparring Boys: |
Youth Sparring Girls: |
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| Youth Musical Forms: |
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Youth Musical Weapons: |
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| Adult Under Belt Divisions |
| Men's Forms: |
Women's Forms: |
Adult Weapons: |
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| Men Sparring: |
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Women Sparring: |
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| Adult Musical Forms: |
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| Specialty Divisions |
| Self Defense: |
Breaking: |
Team Fighting: |
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| Team Forms: |
Handicap: |
Continuous Fighting: |
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Jiu-Jitsu: |
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| WKC Divisions |
| Forms Hardstyle: |
Forms Korean: |
Forms Kenpo: |
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| Forms Chinese/Softstyle: |
Forms Freestyle: |
Forms Extreme: |
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| Forms Classical: |
Forms Traditional: |
Traditional Weapons |
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| Creative Weapons: |
Open/Musical Weapons: |
Sparring:Girls 10 & Under: |
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| Sparring:Girls 11-12: |
Sparring:Girls 13-14: |
Sparring:Girls 15-17: |
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| Sparring:Womens 18+ |
Sparring:Womens 35: |
Sparring:Womens 42: |
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| Sparring:Womens 48: |
Sparring:Boys 10 & Under: |
Sparring:Boys 11-12: |
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| Sparring:Boys 13-14: |
Sparring:Boys 15-17: |
Sparring:Mens 18+: |
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| Sparring:Mens 35: |
Sparring:Mens 42: |
Sparring:Mens 48: |
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| Spectator & Coach Passes |
| Spectator Pass(s): |
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Coach Pass(s): |
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| Payment Information |
| To make your payment add the appropriate item(s) listed below to your PayPal Shopping Cart. On next page update the quantity as needed and complete the payment process. |
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Select the appropriate item(s) to your PayPal Shopping Cart. |
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